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 $85.11 Median $85.11 Typical High $102.33 | Professional | None | $85.11 | $85.11 | $102.33 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $144.54 | Professional | None | $114.82 | $114.82 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | None | $107.15 | $107.15 | $147.91 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $316.23 | Professional | None | $147.91 | $208.93 | $316.23 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $162.18 | Professional | None | $85.11 | $102.33 | $162.18 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $177.83 | Professional | None | $112.20 | $112.20 | $177.83 |
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 $41.69 Median $41.69 Typical High $51.29 | Professional | 52 · Reduced service | $41.69 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $20.42 | Professional | 53 · Discontinued | $16.98 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $10.23 |
Where Maryland sits
The same service costs 5.4 times more in Kansas 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· 40th of 51
$112
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.