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 $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
CareFirst Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $41.69 | Professional | None | $33.11 | $33.11 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $91.20 | Professional | None | $42.66 | $61.66 | $91.20 |
United Setting Professional Modifier None Typical Low $24.55 Median $30.20 Typical High $46.77 | Professional | None | $24.55 | $30.20 | $46.77 |
Wellpoint Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $51.29 | Professional | None | $33.11 | $33.11 | $51.29 |
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 $12.30 Median $12.30 Typical High $14.79 | Professional | 52 · Reduced service | $12.30 | $12.30 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.89 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $4.47 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.95 |
Where Maryland sits
The same service costs 2.8 times more in Montana than in Kansas. 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· 39th of 51
$33.11
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.