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 $18.20 Median $18.20 Typical High $22.39 | Professional | None | $18.20 | $18.20 | $22.39 |
CareFirst Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $31.62 | Professional | None | $23.44 | $23.44 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $45.71 Typical High $69.18 | Professional | None | $32.36 | $45.71 | $69.18 |
United Setting Professional Modifier None Typical Low $18.62 Median $22.39 Typical High $35.48 | Professional | None | $18.62 | $22.39 | $35.48 |
Wellpoint Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $38.90 | Professional | None | $24.55 | $24.55 | $38.90 |
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 $9.12 Median $9.12 Typical High $11.22 | Professional | 52 · Reduced service | $9.12 | $9.12 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $4.47 | Professional | 53 · Discontinued | $3.63 | $3.63 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $3.31 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $2.24 |
Where Maryland sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 43rd of 51
$23.44
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.