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 $52.48 Median $52.48 Typical High $61.66 | Professional | None | $52.48 | $52.48 | $61.66 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $89.13 | Professional | None | $69.18 | $69.18 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $194.98 | Professional | None | $91.20 | $131.83 | $194.98 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $69.18 | Facility | None | $61.66 | $61.66 | $69.18 |
United Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $102.33 | Professional | None | $47.86 | $64.57 | $102.33 |
Wellpoint Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $112.20 | Professional | None | $63.10 | $63.10 | $112.20 |
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 $26.30 Median $26.30 Typical High $29.51 | Professional | 52 · Reduced service | $26.30 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $11.75 | Professional | 53 · Discontinued | $10.47 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $8.91 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $5.89 |
Where Maryland sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 31st of 51
$64.57
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.