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 $61.66 Median $61.66 Typical High $83.18 | Professional | None | $61.66 | $61.66 | $83.18 |
CareFirst Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $104.71 | Professional | None | $81.28 | $81.28 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $229.09 | Professional | None | $107.15 | $154.88 | $229.09 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Facility | None | $95.50 | $95.50 | $100.00 |
United Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $120.23 | Professional | None | $67.61 | $75.86 | $120.23 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $131.83 | Professional | None | $91.20 | $91.20 | $131.83 |
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 $30.90 Median $30.90 Typical High $37.15 | Professional | 52 · Reduced service | $30.90 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $14.79 | Professional | 53 · Discontinued | $12.30 | $12.30 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $11.22 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $7.41 |
Where Maryland sits
The same service costs 3.2 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· 43rd of 51
$81.28
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.