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 $23.99 Median $23.99 Typical High $28.84 | Professional | None | $23.99 | $23.99 | $28.84 |
CareFirst Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $58.88 Typical High $89.13 | Professional | None | $41.69 | $58.88 | $89.13 |
United Setting Professional Modifier None Typical Low $23.99 Median $28.84 Typical High $45.71 | Professional | None | $23.99 | $28.84 | $45.71 |
Wellpoint Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $50.12 | Professional | None | $31.62 | $31.62 | $50.12 |
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 $12.02 Median $12.02 Typical High $14.45 | Professional | 52 · Reduced service | $12.02 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $5.75 | Professional | 53 · Discontinued | $4.79 | $4.79 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $4.37 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $2.88 |
Where Maryland sits
The same service costs 2.8 times more in Kansas 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· 34th of 51
$31.62
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.