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 $30.90 Median $30.90 Typical High $37.15 | Professional | None | $30.90 | $30.90 | $37.15 |
CareFirst Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $52.48 | Professional | None | $39.81 | $39.81 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $114.82 | Professional | None | $53.70 | $75.86 | $114.82 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $30.20 Median $37.15 Typical High $58.88 | Professional | None | $30.20 | $37.15 | $58.88 |
Wellpoint Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $64.57 | Professional | None | $39.81 | $39.81 | $64.57 |
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 $15.49 Median $15.49 Typical High $18.20 | Professional | 52 · Reduced service | $15.49 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $7.41 | Professional | 53 · Discontinued | $6.17 | $6.17 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $5.50 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.63 |
Where Maryland sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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· 48th of 51
$39.81
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.