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 $20.89 Median $20.89 Typical High $25.70 | Professional | None | $20.89 | $20.89 | $25.70 |
CareFirst Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $35.48 | Professional | None | $26.92 | $26.92 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $36.31 Median $51.29 Typical High $77.62 | Professional | None | $36.31 | $51.29 | $77.62 |
United Setting Professional Modifier None Typical Low $20.89 Median $25.12 Typical High $39.81 | Professional | None | $20.89 | $25.12 | $39.81 |
Wellpoint Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $43.65 | Professional | None | $28.18 | $28.18 | $43.65 |
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 $10.47 Median $10.47 Typical High $12.59 | Professional | 52 · Reduced service | $10.47 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $5.01 | Professional | 53 · Discontinued | $4.17 | $4.17 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $3.80 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.51 |
Where Maryland sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 41st of 51
$26.92
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.