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 $23.99 Median $23.99 Typical High $30.90 | Professional | None | $23.99 | $23.99 | $30.90 |
CareFirst Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $40.74 | Professional | None | $30.90 | $30.90 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $58.88 Typical High $89.13 | Professional | None | $41.69 | $58.88 | $89.13 |
United Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Facility | None | $35.48 | $35.48 | $38.02 |
United Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $46.77 | Professional | None | $26.30 | $28.84 | $46.77 |
Wellpoint Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $50.12 | Professional | None | $34.67 | $34.67 | $50.12 |
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 $12.02 Median $12.02 Typical High $15.49 | Professional | 52 · Reduced service | $12.02 | $12.02 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $6.17 | Professional | 53 · Discontinued | $4.79 | $4.79 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $4.57 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $3.09 |
Where Maryland sits
The same service costs 3.0 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
$30.90
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.