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 $257.04 Median $257.04 Typical High $295.12 | Professional | None | $257.04 | $257.04 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $446.68 | Professional | None | $338.84 | $338.84 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | None | $239.88 | $239.88 | $331.13 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $977.24 | Professional | None | $446.68 | $645.65 | $977.24 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $363.08 | Facility | None | $354.81 | $354.81 | $363.08 |
United Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $501.19 | Professional | None | $239.88 | $316.23 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $549.54 | Professional | None | $316.23 | $316.23 | $549.54 |
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 $128.82 Median $128.82 Typical High $144.54 | Professional | 52 · Reduced service | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $57.54 | Professional | 53 · Discontinued | $51.29 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $42.66 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $28.84 |
Where Maryland sits
The same service costs 4.1 times more in Hawaii than in Florida. 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· 40th of 51
$316
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.