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 $218.78 Median $218.78 Typical High $269.15 | Professional | None | $218.78 | $218.78 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $371.54 | Professional | None | $288.40 | $288.40 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $812.83 | Professional | None | $380.19 | $549.54 | $812.83 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $407.38 | Facility | None | $354.81 | $354.81 | $407.38 |
United Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $426.58 | Professional | None | $239.88 | $269.15 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $467.74 | Professional | None | $323.59 | $323.59 | $467.74 |
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 $109.65 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $109.65 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $53.70 | Professional | 53 · Discontinued | $43.65 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $40.74 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $26.92 |
Where Maryland sits
The same service costs 4.2 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· 42nd of 51
$288
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.