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 $831.76 Median $831.76 Typical High $1,000.00 | Professional | None | $831.76 | $831.76 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,096.48 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None | $851.14 | $851.14 | $1,174.90 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,445.44 | $2,041.74 | $3,090.30 |
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 $851.14 Median $1,000.00 Typical High $1,621.81 | Professional | None | $851.14 | $1,000.00 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,122.02 | $1,737.80 |
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 $416.87 Median $416.87 Typical High $501.19 | Professional | 52 · Reduced service | $416.87 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | 53 · Discontinued | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $100.00 |
Where Maryland sits
The same service costs 3.3 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· 41st of 51
$1,096
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.