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 $208.93 Median $208.93 Typical High $269.15 | Professional | None | $208.93 | $208.93 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $363.08 | Professional | None | $275.42 | $275.42 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $776.25 | Professional | None | $363.08 | $524.81 | $776.25 |
United Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $363.08 | Facility | None | $338.84 | $338.84 | $363.08 |
United Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $407.38 | Professional | None | $229.09 | $257.04 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $446.68 | Professional | None | $309.03 | $316.23 | $446.68 |
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 $104.71 Median $104.71 Typical High $128.82 | Professional | 52 · Reduced service | $104.71 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $51.29 | Professional | 53 · Discontinued | $41.69 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $25.70 |
Where Maryland sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 46th of 51
$275
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.