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 $20.42 Median $20.42 Typical High $24.55 | Professional | None | $20.42 | $20.42 | $24.55 |
CareFirst Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $34.67 | Professional | None | $31.62 | $31.62 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $50.12 Typical High $75.86 | Professional | None | $35.48 | $50.12 | $75.86 |
United Setting Professional Modifier None Typical Low $20.42 Median $24.55 Typical High $38.90 | Professional | None | $20.42 | $24.55 | $38.90 |
Wellpoint Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $42.66 | Professional | None | $26.92 | $26.92 | $42.66 |
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 $10.00 Median $10.00 Typical High $12.30 | Professional | 52 · Reduced service | $10.00 | $10.00 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.90 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.63 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.45 |
Where Maryland sits
The same service costs 2.2 times more in Montana than in Arizona. 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
$26.92
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.