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 $478.63 Median $478.63 Typical High $630.96 | Professional | None | $478.63 | $478.63 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $831.76 | Professional | None | $630.96 | $630.96 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,819.70 | Professional | None | $831.76 | $1,202.26 | $1,819.70 |
United Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $912.01 | Facility | None | $776.25 | $776.25 | $912.01 |
United Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $933.25 | Professional | None | $524.81 | $588.84 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $707.95 Typical High $1,023.29 | Professional | None | $371.54 | $707.95 | $1,023.29 |
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 $239.88 Median $239.88 Typical High $302.00 | Professional | 52 · Reduced service | $239.88 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $91.20 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $60.26 |
Where Maryland sits
The same service costs 4.6 times more in Hawaii 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· 46th of 51
$631
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.