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 $63.10 Median $63.10 Typical High $75.86 | Professional | None | $63.10 | $63.10 | $75.86 |
CareFirst Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $107.15 | Professional | None | $81.28 | $81.28 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $234.42 | Professional | None | $109.65 | $154.88 | $234.42 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $69.18 | Facility | None | $39.81 | $39.81 | $69.18 |
United Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $120.23 | Professional | None | $63.10 | $75.86 | $120.23 |
Wellpoint Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $131.83 | Professional | None | $83.18 | $83.18 | $131.83 |
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 $31.62 Median $31.62 Typical High $38.02 | Professional | 52 · Reduced service | $31.62 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $15.14 | Professional | 53 · Discontinued | $12.59 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $11.22 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $7.59 |
Where Maryland sits
The same service costs 2.5 times more in Montana 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
$81.28
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.