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 $123.03 Median $123.03 Typical High $165.96 | Professional | None | $123.03 | $123.03 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $213.80 | Professional | None | $162.18 | $162.18 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $467.74 | Professional | None | $218.78 | $309.03 | $467.74 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Facility | None | $125.89 | $125.89 | $173.78 |
United Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $239.88 | Professional | None | $138.04 | $151.36 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $263.03 | Professional | None | $181.97 | $181.97 | $263.03 |
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 $61.66 Median $61.66 Typical High $81.28 | Professional | 52 · Reduced service | $61.66 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $32.36 | Professional | 53 · Discontinued | $25.12 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $24.55 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $16.22 |
Where Maryland sits
The same service costs 2.7 times more in Hawaii than in Delaware. 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· 46th of 51
$162
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.