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 $125.89 Median $125.89 Typical High $158.49 | Professional | None | $125.89 | $125.89 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $213.80 | Professional | None | $165.96 | $165.96 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $467.74 | Professional | None | $218.78 | $316.23 | $467.74 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Facility | None | $199.53 | $199.53 | $204.17 |
United Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $245.47 | Professional | None | $138.04 | $154.88 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $269.15 | Professional | None | $181.97 | $181.97 | $269.15 |
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 $63.10 Median $63.10 Typical High $79.43 | Professional | 52 · Reduced service | $63.10 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $31.62 | Professional | 53 · Discontinued | $25.12 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $23.44 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $15.85 |
Where Maryland sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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
$166
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.