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 $891.25 Median $891.25 Typical High $1,122.02 | Professional | None | $891.25 | $891.25 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,148.15 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $2,187.76 Typical High $3,311.31 | Professional | None | $1,548.82 | $2,187.76 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,258.93 | Facility | None | $1,122.02 | $1,122.02 | $1,258.93 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,737.80 | Professional | None | $954.99 | $1,071.52 | $1,737.80 |
Wellpoint Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,258.93 | $1,862.09 |
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 $446.68 Median $446.68 Typical High $549.54 | Professional | 52 · Reduced service | $446.68 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $218.78 | Professional | 53 · Discontinued | $177.83 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $165.96 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $109.65 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $109.65 |
Where Maryland sits
The same service costs 2.9 times more in Hawaii 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
$1,148
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.