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 $43.65 Median $43.65 Typical High $50.12 | Professional | None | $43.65 | $43.65 | $50.12 |
CareFirst Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $74.13 | Professional | None | $57.54 | $57.54 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $162.18 | Professional | None | $75.86 | $109.65 | $162.18 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $93.33 | Facility | None | $63.10 | $63.10 | $93.33 |
United Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $85.11 | Professional | None | $42.66 | $53.70 | $85.11 |
Wellpoint Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $93.33 | Professional | None | $56.23 | $56.23 | $93.33 |
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 $21.88 Median $21.88 Typical High $25.12 | Professional | 52 · Reduced service | $21.88 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $10.23 | Professional | 53 · Discontinued | $8.71 | $8.71 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $7.59 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $5.13 |
Where Maryland sits
The same service costs 4.4 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· 47th of 51
$57.54
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.