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 $204.17 Median $204.17 Typical High $245.47 | Professional | None | $204.17 | $204.17 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $346.74 | Professional | None | $263.03 | $263.03 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $758.58 | Professional | None | $354.81 | $501.19 | $758.58 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $426.58 | Facility | None | $331.13 | $331.13 | $426.58 |
United Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $389.05 | Professional | None | $223.87 | $245.47 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $426.58 | Professional | None | $295.12 | $295.12 | $426.58 |
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 $100.00 Median $100.00 Typical High $123.03 | Professional | 52 · Reduced service | $100.00 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $40.74 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $24.55 |
Where Maryland sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 50th of 51
$275
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.