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 $38.90 Median $38.90 Typical High $47.86 | Professional | None | $38.90 | $38.90 | $47.86 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $67.61 | Professional | None | $53.70 | $53.70 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $147.91 | Professional | None | $67.61 | $97.72 | $147.91 |
United Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $75.86 | Professional | None | $39.81 | $47.86 | $75.86 |
Wellpoint Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $83.18 | Professional | None | $52.48 | $52.48 | $83.18 |
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 $19.50 Median $19.50 Typical High $23.44 | Professional | 52 · Reduced service | $19.50 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $9.55 | Professional | 53 · Discontinued | $7.76 | $7.76 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $7.08 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $4.68 |
Where Maryland sits
The same service costs 2.0 times more in Hawaii than in West Virginia. 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· 34th of 51
$52.48
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.