How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $616.60 | Professional | None | $309.03 | $309.03 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Facility | None | $630.96 | $630.96 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $1,047.13 | Professional | None | $467.74 | $691.83 | $1,047.13 |
United Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $831.76 | Professional | None | $478.63 | $549.54 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $416.87 Typical High $812.83 | Professional | None | $239.88 | $416.87 | $812.83 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | 52 · Reduced service | $154.88 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $85.11 | Professional | 53 · Discontinued | $61.66 | $61.66 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $42.66 |
Where Maryland sits
The same service costs 2.2 times more in Kansas than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maryland· 37th of 51
$550
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.