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 $162.18 Median $162.18 Typical High $194.98 | Professional | None | $162.18 | $162.18 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $275.42 | Professional | None | $208.93 | $208.93 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $602.56 | Professional | None | $281.84 | $398.11 | $602.56 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Facility | None | $147.91 | $147.91 | $204.17 |
United Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $309.03 | Professional | None | $177.83 | $194.98 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $338.84 | Professional | None | $234.42 | $234.42 | $338.84 |
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 $81.28 Median $81.28 Typical High $97.72 | Professional | 52 · Reduced service | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $38.90 | Professional | 53 · Discontinued | $32.36 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $29.51 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $19.50 |
Where Maryland sits
The same service costs 2.9 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· 44th of 51
$209
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.