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 $14.13 Median $14.13 Typical High $16.98 | Professional | None | $14.13 | $14.13 | $16.98 |
CareFirst Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | None | $20.89 | $20.89 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $35.48 Typical High $52.48 | Professional | None | $24.55 | $35.48 | $52.48 |
United Setting Professional Modifier None Typical Low $14.13 Median $16.98 Typical High $26.92 | Professional | None | $14.13 | $16.98 | $26.92 |
Wellpoint Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $29.51 | Professional | None | $19.05 | $19.05 | $29.51 |
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 $7.08 Median $7.08 Typical High $8.51 | Professional | 52 · Reduced service | $7.08 | $7.08 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $3.39 | Professional | 53 · Discontinued | $2.82 | $2.82 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $2.51 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $1.70 |
Where Maryland sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$19.05
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.