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 $15.14 Median $15.14 Typical High $18.62 | Professional | None | $15.14 | $15.14 | $18.62 |
CareFirst Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.92 Median $38.02 Typical High $57.54 | Professional | None | $26.92 | $38.02 | $57.54 |
United Setting Professional Modifier None Typical Low $15.49 Median $18.62 Typical High $29.51 | Professional | None | $15.49 | $18.62 | $29.51 |
Wellpoint Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $32.36 | Professional | None | $20.42 | $20.42 | $32.36 |
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 $7.59 Median $7.59 Typical High $9.33 | Professional | 52 · Reduced service | $7.59 | $7.59 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.09 Typical High $3.72 | Professional | 53 · Discontinued | $3.09 | $3.09 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.29 Typical High $2.75 | Professional | 55 · Aftercare only | $2.29 | $2.29 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.51 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.51 | $1.51 | $1.86 |
Where Maryland sits
The same service costs 2.2 times more in Montana than in New Jersey. 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· 38th of 51
$20.42
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.