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 $41.69 Median $41.69 Typical High $50.12 | Professional | None | $41.69 | $41.69 | $50.12 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | None | $53.70 | $53.70 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $158.49 | Professional | None | $72.44 | $104.71 | $158.49 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $60.26 | Facility | None | $32.36 | $32.36 | $60.26 |
United Setting Professional Modifier None Typical Low $42.66 Median $51.29 Typical High $81.28 | Professional | None | $42.66 | $51.29 | $81.28 |
Wellpoint Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $89.13 | Professional | None | $56.23 | $56.23 | $89.13 |
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 $20.89 Median $20.89 Typical High $25.12 | Professional | 52 · Reduced service | $20.89 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $10.23 | Professional | 53 · Discontinued | $8.32 | $8.32 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $7.59 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $5.13 |
Where Maryland sits
The same service costs 2.1 times more in Montana 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· 42nd of 51
$53.70
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.