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 $53.70 Median $53.70 Typical High $66.07 | Professional | None | $53.70 | $53.70 | $66.07 |
CareFirst Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $93.33 | Professional | None | $70.79 | $70.79 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $107.15 | Professional | None | $77.62 | $77.62 | $107.15 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $204.17 | Professional | None | $95.50 | $134.90 | $204.17 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $870.96 | Facility | None | $89.13 | $89.13 | $870.96 |
United Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $104.71 | Professional | None | $60.26 | $66.07 | $104.71 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $114.82 | Professional | None | $79.43 | $79.43 | $114.82 |
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 $26.92 Median $26.92 Typical High $33.11 | Professional | 52 · Reduced service | $26.92 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $13.18 | Professional | 53 · Discontinued | $10.96 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $9.77 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $6.61 |
Where Maryland sits
The same service costs 5.1 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· 49th of 51
$75.86
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.