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 $77.62 Median $77.62 Typical High $93.33 | Professional | None | $77.62 | $77.62 | $93.33 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Professional | None | $107.15 | $107.15 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $128.82 | Professional | None | $95.50 | $95.50 | $128.82 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $288.40 | Professional | None | $134.90 | $194.98 | $288.40 |
United Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $151.36 | Professional | None | $79.43 | $95.50 | $151.36 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $104.71 Typical High $165.96 | Professional | None | $57.54 | $104.71 | $165.96 |
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 $38.90 Median $38.90 Typical High $46.77 | Professional | 52 · Reduced service | $38.90 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $18.62 | Professional | 53 · Discontinued | $15.49 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $14.13 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $9.33 |
Where Maryland sits
The same service costs 2.5 times more in Kansas than in Utah. 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· 40th of 51
$105
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.