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 $102.33 Median $102.33 Typical High $112.20 | Professional | None | $102.33 | $102.33 | $112.20 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $173.78 | Professional | None | $134.90 | $134.90 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $380.19 | Professional | None | $177.83 | $251.19 | $380.19 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $194.98 | Professional | None | $91.20 | $123.03 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $213.80 | Professional | None | $120.23 | $120.23 | $213.80 |
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 $51.29 Median $51.29 Typical High $56.23 | Professional | 52 · Reduced service | $51.29 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $22.91 | Professional | 53 · Discontinued | $20.42 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $11.22 |
Where Maryland sits
The same service costs 2.5 times more in Montana 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· 36th of 51
$123
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.