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 $35.48 Median $35.48 Typical High $50.12 | Professional | None | $35.48 | $35.48 | $50.12 |
CareFirst Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $60.26 | Professional | None | $45.71 | $45.71 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $131.83 | Professional | None | $61.66 | $89.13 | $131.83 |
United Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $69.18 | Professional | None | $36.31 | $43.65 | $69.18 |
Wellpoint Setting Professional Modifier None Typical Low $30.20 Median $47.86 Typical High $75.86 | Professional | None | $30.20 | $47.86 | $75.86 |
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 $17.78 Median $17.78 Typical High $21.38 | Professional | 52 · Reduced service | $17.78 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $8.51 | Professional | 53 · Discontinued | $7.08 | $7.08 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $6.46 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $4.27 |
Where Maryland sits
The same service costs 3.0 times more in Hawaii 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· 40th of 51
$45.71
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.