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 $42.66 Median $42.66 Typical High $64.57 | Professional | None | $42.66 | $42.66 | $64.57 |
CareFirst Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $74.13 | Professional | None | $56.23 | $56.23 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $162.18 | Professional | None | $74.13 | $107.15 | $162.18 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Facility | None | $43.65 | $43.65 | $51.29 |
United Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $83.18 | Professional | None | $40.74 | $52.48 | $83.18 |
Wellpoint Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $91.20 | Professional | None | $40.74 | $53.70 | $91.20 |
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 $21.38 Median $21.38 Typical High $25.12 | Professional | 52 · Reduced service | $21.38 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | 53 · Discontinued | $8.51 | $8.51 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $7.41 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $5.01 |
Where Maryland sits
The same service costs 2.6 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· 45th of 51
$53.70
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.