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 $47.86 Median $47.86 Typical High $51.29 | Professional | None | $47.86 | $47.86 | $51.29 |
CareFirst Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $81.28 | Professional | None | $63.10 | $63.10 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $66.07 | Professional | None | $47.86 | $47.86 | $66.07 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $177.83 | Professional | None | $83.18 | $120.23 | $177.83 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $60.26 | Facility | None | $58.88 | $58.88 | $60.26 |
United Setting Professional Modifier None Typical Low $39.81 Median $58.88 Typical High $89.13 | Professional | None | $39.81 | $58.88 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $102.33 | Professional | None | $52.48 | $52.48 | $102.33 |
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 $23.99 Median $23.99 Typical High $25.70 | Professional | 52 · Reduced service | $23.99 | $23.99 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $10.23 | Professional | 53 · Discontinued | $9.55 | $9.55 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $7.76 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $5.13 |
Where Maryland sits
The same service costs 3.6 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· 29th of 51
$58.88
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.