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 $109.65 Median $109.65 Typical High $177.83 | Professional | None | $109.65 | $109.65 | $177.83 |
CareFirst Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | None | $177.83 | $177.83 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $144.54 | Facility | None | $141.25 | $141.25 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None | $104.71 | $104.71 | $141.25 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $407.38 | Professional | None | $190.55 | $275.42 | $407.38 |
United Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $218.78 | Professional | None | $123.03 | $134.90 | $218.78 |
Wellpoint Setting Professional Modifier None Typical Low $40.74 Median $147.91 Typical High $234.42 | Professional | None | $40.74 | $147.91 | $234.42 |
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 $54.95 Median $54.95 Typical High $66.07 | Professional | 52 · Reduced service | $54.95 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $26.30 | Professional | 53 · Discontinued | $21.88 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $19.95 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $13.18 |
Where Maryland sits
The same service costs 2.2 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· 41st of 51
$148
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.