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 $30.20 Median $30.20 Typical High $36.31 | Professional | None | $30.20 | $30.20 | $36.31 |
CareFirst Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $51.29 | Professional | None | $46.77 | $46.77 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $112.20 | Professional | None | $52.48 | $74.13 | $112.20 |
United Setting Professional Modifier None Typical Low $30.20 Median $36.31 Typical High $57.54 | Professional | None | $30.20 | $36.31 | $57.54 |
Wellpoint Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $63.10 | Professional | None | $39.81 | $39.81 | $63.10 |
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 $15.14 Median $15.14 Typical High $18.20 | Professional | 52 · Reduced service | $15.14 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $7.24 | Professional | 53 · Discontinued | $6.03 | $6.03 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $5.37 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.63 |
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
$39.81
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.