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 $269.15 Median $269.15 Typical High $346.74 | Professional | None | $269.15 | $269.15 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $467.74 | Professional | None | $398.11 | $398.11 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $1,023.29 | Professional | None | $467.74 | $676.08 | $1,023.29 |
United Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $524.81 | Professional | None | $275.42 | $331.13 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $575.44 | Professional | None | $316.23 | $363.08 | $575.44 |
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 $134.90 Median $134.90 Typical High $162.18 | Professional | 52 · Reduced service | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $66.07 | Professional | 53 · Discontinued | $53.70 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $32.36 |
Where Maryland sits
The same service costs 2.2 times more in Montana 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· 40th of 51
$363
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.