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 $66.07 Median $66.07 Typical High $74.13 | Professional | None | $66.07 | $66.07 | $74.13 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | None | $85.11 | $85.11 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $245.47 | Professional | None | $114.82 | $165.96 | $245.47 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $114.82 | Facility | None | $93.33 | $93.33 | $114.82 |
United Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $125.89 | Professional | None | $63.10 | $79.43 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $138.04 | Professional | None | $83.18 | $83.18 | $138.04 |
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 $33.11 Median $33.11 Typical High $36.31 | Professional | 52 · Reduced service | $33.11 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $14.79 | Professional | 53 · Discontinued | $13.18 | $13.18 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.96 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $7.41 |
Where Maryland sits
The same service costs 5.1 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· 39th of 51
$83.18
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.