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 $363.08 Median $363.08 Typical High $436.52 | Professional | None | $363.08 | $363.08 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $616.60 | Professional | None | $478.63 | $478.63 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,348.96 | Professional | None | $630.96 | $912.01 | $1,348.96 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $562.34 | Facility | None | $537.03 | $537.03 | $562.34 |
United Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $691.83 | Professional | None | $363.08 | $446.68 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $776.25 | Professional | None | $478.63 | $478.63 | $776.25 |
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 $181.97 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $181.97 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $87.10 | Professional | 53 · Discontinued | $72.44 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $43.65 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $43.65 |
Where Maryland sits
The same service costs 3.9 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· 39th of 51
$479
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.