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 $93.33 Median $93.33 Typical High $112.20 | Professional | None | $93.33 | $93.33 | $112.20 |
CareFirst Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $158.49 | Professional | None | $120.23 | $120.23 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $346.74 | Professional | None | $162.18 | $229.09 | $346.74 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $389.05 | Facility | None | $151.36 | $151.36 | $389.05 |
United Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $181.97 | Professional | None | $102.33 | $112.20 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $194.98 | Professional | None | $134.90 | $134.90 | $194.98 |
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 $45.71 Median $45.71 Typical High $56.23 | Professional | 52 · Reduced service | $45.71 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $22.39 | Professional | 53 · Discontinued | $18.62 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $16.60 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $11.22 |
Where Maryland sits
The same service costs 8.1 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· 43rd of 51
$120
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.