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 $331.13 Median $331.13 Typical High $524.81 | Professional | None | $331.13 | $331.13 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $562.34 | Professional | None | $426.58 | $426.58 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,230.27 | Professional | None | $575.44 | $812.83 | $1,230.27 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $436.52 | Facility | None | $331.13 | $331.13 | $436.52 |
United Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $645.65 | Professional | None | $363.08 | $398.11 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $691.83 | Professional | None | $371.54 | $478.63 | $691.83 |
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 $162.18 Median $162.18 Typical High $218.78 | Professional | 52 · Reduced service | $162.18 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $87.10 | Professional | 53 · Discontinued | $66.07 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $43.65 |
Where Maryland sits
The same service costs 2.4 times more in Iowa 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· 48th of 51
$427
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.