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 $51.29 Median $51.29 Typical High $61.66 | Professional | None | $51.29 | $51.29 | $61.66 |
CareFirst Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $87.10 | Professional | None | $64.57 | $64.57 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $190.55 | Professional | None | $89.13 | $125.89 | $190.55 |
United Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $97.72 | Professional | None | $51.29 | $61.66 | $97.72 |
Wellpoint Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $107.15 | Professional | None | $67.61 | $67.61 | $107.15 |
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 $25.70 Median $25.70 Typical High $30.90 | Professional | 52 · Reduced service | $25.70 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $12.30 | Professional | 53 · Discontinued | $10.23 | $10.23 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $9.12 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $6.17 |
Where Maryland sits
The same service costs 2.6 times more in Hawaii 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· 41st of 51
$64.57
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.