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 $194.98 Median $194.98 Typical High $234.42 | Professional | None | $194.98 | $194.98 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $331.13 | Professional | None | $257.04 | $257.04 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | None | $218.78 | $218.78 | $295.12 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $724.44 | Professional | None | $338.84 | $489.78 | $724.44 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
United Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $380.19 | Professional | None | $213.80 | $239.88 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $416.87 | Professional | None | $288.40 | $288.40 | $416.87 |
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 $97.72 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $38.90 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $35.48 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $23.44 |
Where Maryland sits
The same service costs 4.2 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· 42nd of 51
$257
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.