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 $645.65 Median $645.65 Typical High $794.33 | Professional | None | $645.65 | $645.65 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,096.48 | Professional | None | $831.76 | $831.76 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,584.89 | $2,398.83 |
United Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $870.96 | Facility | None | $707.95 | $707.95 | $870.96 |
United Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,230.27 | Professional | None | $645.65 | $776.25 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,348.96 | Professional | None | $851.14 | $851.14 | $1,348.96 |
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 $316.23 Median $316.23 Typical High $398.11 | Professional | 52 · Reduced service | $316.23 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | 53 · Discontinued | $128.82 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $117.49 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $79.43 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $79.43 |
Where Maryland sits
The same service costs 3.0 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· 40th of 51
$832
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.