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 $87.10 Median $87.10 Typical High $97.72 | Professional | None | $87.10 | $87.10 | $97.72 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $147.91 | Professional | None | $114.82 | $114.82 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $323.59 | Professional | None | $151.36 | $218.78 | $323.59 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $85.11 | Facility | None | $72.44 | $72.44 | $85.11 |
United Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $165.96 | Professional | None | $77.62 | $104.71 | $165.96 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $186.21 | Professional | None | $102.33 | $102.33 | $186.21 |
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 $43.65 Median $43.65 Typical High $47.86 | Professional | 52 · Reduced service | $43.65 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $19.50 | Professional | 53 · Discontinued | $17.38 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $14.45 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $9.77 |
Where Maryland sits
The same service costs 2.4 times more in Montana than in Vermont. 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· 30th of 51
$105
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.