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 $36.31 Median $36.31 Typical High $44.67 | Professional | None | $36.31 | $36.31 | $44.67 |
CareFirst Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $63.10 | Professional | None | $48.98 | $48.98 | $63.10 |
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 $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $138.04 | Professional | None | $64.57 | $91.20 | $138.04 |
United Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $70.79 | Professional | None | $37.15 | $44.67 | $70.79 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $77.62 | Professional | None | $48.98 | $48.98 | $77.62 |
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 $18.20 Median $18.20 Typical High $22.39 | Professional | 52 · Reduced service | $18.20 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $8.91 | Professional | 53 · Discontinued | $7.41 | $7.41 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $6.61 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $4.47 |
Where Maryland sits
The same service costs 2.3 times more in Montana than in Florida. 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· 33rd of 51
$48.98
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.