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 $21.88 Median $21.88 Typical High $27.54 | Professional | None | $21.88 | $21.88 | $27.54 |
CareFirst Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $37.15 | Professional | None | $28.84 | $28.84 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None | $28.84 | $28.84 | $38.90 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $81.28 | Professional | None | $38.02 | $54.95 | $81.28 |
United Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $51.29 | Facility | None | $35.48 | $35.48 | $51.29 |
United Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $42.66 | Professional | None | $23.99 | $26.92 | $42.66 |
Wellpoint Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $46.77 | Professional | None | $32.36 | $32.36 | $46.77 |
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 $10.96 Median $10.96 Typical High $13.18 | Professional | 52 · Reduced service | $10.96 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $5.25 | Professional | 53 · Discontinued | $4.37 | $4.37 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $3.98 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.63 |
Where Maryland sits
The same service costs 4.7 times more in Hawaii than in Florida. 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· 48th of 51
$28.84
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.