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 $40.74 Median $40.74 Typical High $50.12 | Professional | None | $40.74 | $40.74 | $50.12 |
CareFirst Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $70.79 | Professional | None | $52.48 | $52.48 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $154.88 | Professional | None | $70.79 | $102.33 | $154.88 |
United Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $79.43 | Professional | None | $41.69 | $50.12 | $79.43 |
Wellpoint Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $87.10 | Professional | None | $54.95 | $54.95 | $87.10 |
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 $20.42 Median $20.42 Typical High $24.55 | Professional | 52 · Reduced service | $20.42 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $10.00 | Professional | 53 · Discontinued | $8.13 | $8.13 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $7.41 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $5.01 |
Where Maryland sits
The same service costs 2.6 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· 40th 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.