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 $575.44 Median $575.44 Typical High $660.69 | Professional | None | $575.44 | $575.44 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $977.24 | Professional | None | $741.31 | $741.31 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $831.76 | Professional | None | $602.56 | $602.56 | $831.76 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,412.54 | $2,137.96 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,348.96 | Facility | None | $870.96 | $870.96 | $1,348.96 |
United Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,096.48 | Professional | None | $602.56 | $691.83 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,202.26 | Professional | None | $794.33 | $794.33 | $1,202.26 |
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 $288.40 Median $288.40 Typical High $331.13 | Professional | 52 · Reduced service | $288.40 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | 53 · Discontinued | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $66.07 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $66.07 |
Where Maryland sits
The same service costs 5.4 times more in Hawaii than in Florida. 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
$741
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.