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 $602.56 Median $602.56 Typical High $741.31 | Professional | None | $602.56 | $602.56 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,047.13 | Professional | None | $794.33 | $794.33 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | None | $616.60 | $616.60 | $851.14 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,513.56 | $2,290.87 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $776.25 | Facility | None | $630.96 | $630.96 | $776.25 |
United Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,174.90 | Professional | None | $616.60 | $741.31 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,288.25 | Professional | None | $812.83 | $812.83 | $1,288.25 |
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 $302.00 Median $302.00 Typical High $371.54 | Professional | 52 · Reduced service | $302.00 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $147.91 | Professional | 53 · Discontinued | $120.23 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $74.13 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $74.13 |
Where Maryland sits
The same service costs 3.0 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· 37th of 51
$794
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.