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 $223.87 Median $223.87 Typical High $331.13 | Professional | None | $223.87 | $223.87 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $389.05 | Professional | None | $338.84 | $338.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $851.14 | Professional | None | $398.11 | $562.34 | $851.14 |
United Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $436.52 | Professional | None | $229.09 | $275.42 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $52.48 Median $302.00 Typical High $478.63 | Professional | None | $52.48 | $302.00 | $478.63 |
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 $112.20 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $112.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $54.95 | Professional | 53 · Discontinued | $44.67 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $27.54 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $27.54 |
Where Maryland sits
The same service costs 2.6 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· 34th of 51
$302
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.