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 $31.62 Median $31.62 Typical High $42.66 | Professional | None | $31.62 | $31.62 | $42.66 |
CareFirst Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $53.70 | Professional | None | $41.69 | $41.69 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $117.49 | Professional | None | $54.95 | $79.43 | $117.49 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $64.57 | Facility | None | $50.12 | $50.12 | $64.57 |
United Setting Professional Modifier None Typical Low $34.67 Median $38.90 Typical High $61.66 | Professional | None | $34.67 | $38.90 | $61.66 |
Wellpoint Setting Professional Modifier None Typical Low $34.67 Median $45.71 Typical High $67.61 | Professional | None | $34.67 | $45.71 | $67.61 |
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 $15.85 Median $15.85 Typical High $19.05 | Professional | 52 · Reduced service | $15.85 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $7.59 | Professional | 53 · Discontinued | $6.31 | $6.31 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $5.75 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.80 |
Where Maryland sits
The same service costs 4.7 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· 45th of 51
$41.69
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.