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 $30.90 Median $30.90 Typical High $38.02 | Professional | None | $30.90 | $30.90 | $38.02 |
CareFirst Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | None | $39.81 | $39.81 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | None | $31.62 | $31.62 | $43.65 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $117.49 | Professional | None | $54.95 | $77.62 | $117.49 |
United Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $60.26 | Professional | None | $31.62 | $38.02 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $66.07 | Professional | None | $41.69 | $41.69 | $66.07 |
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 $15.49 Median $15.49 Typical High $19.05 | Professional | 52 · Reduced service | $15.49 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $7.59 | Professional | 53 · Discontinued | $6.31 | $6.31 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $5.62 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.80 |
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· 42nd 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.