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 $25.70 Median $25.70 Typical High $30.90 | Professional | None | $25.70 | $25.70 | $30.90 |
CareFirst Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $43.65 | Professional | None | $33.11 | $33.11 | $43.65 |
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 $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $95.50 | Professional | None | $44.67 | $63.10 | $95.50 |
United Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $52.48 | Facility | None | $40.74 | $40.74 | $52.48 |
United Setting Professional Modifier None Typical Low $27.54 Median $30.90 Typical High $48.98 | Professional | None | $27.54 | $30.90 | $48.98 |
Wellpoint Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $53.70 | Professional | None | $36.31 | $36.31 | $53.70 |
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 $12.59 Median $12.59 Typical High $15.49 | Professional | 52 · Reduced service | $12.59 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $6.17 | Professional | 53 · Discontinued | $5.13 | $5.13 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $4.57 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $3.09 |
Where Maryland sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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
$34.67
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.