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 $42.66 Median $42.66 Typical High $72.44 | Professional | None | $42.66 | $42.66 | $72.44 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | None | $69.18 | $69.18 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Facility | None | $60.26 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $158.49 | Professional | None | $74.13 | $104.71 | $158.49 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $85.11 | Professional | None | $47.86 | $52.48 | $85.11 |
Wellpoint Setting Professional Modifier None Typical Low $27.54 Median $57.54 Typical High $89.13 | Professional | None | $27.54 | $57.54 | $89.13 |
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 $21.38 Median $21.38 Typical High $25.70 | Professional | 52 · Reduced service | $21.38 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $10.23 | Professional | 53 · Discontinued | $8.51 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $7.59 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $5.13 |
Where Maryland sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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
$57.54
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.