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 $269.15 Median $269.15 Typical High $331.13 | Professional | None | $269.15 | $269.15 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $457.09 | Professional | None | $354.81 | $354.81 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,000.00 | Professional | None | $467.74 | $660.69 | $1,000.00 |
United Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $575.44 | Facility | None | $436.52 | $436.52 | $575.44 |
United Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $512.86 | Professional | None | $295.12 | $323.59 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $562.34 | Professional | None | $389.05 | $389.05 | $562.34 |
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 $134.90 Median $134.90 Typical High $165.96 | Professional | 52 · Reduced service | $134.90 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $66.07 | Professional | 53 · Discontinued | $53.70 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $50.12 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $33.11 |
Where Maryland sits
The same service costs 4.3 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· 44th of 51
$355
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.