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 $323.59 Median $323.59 Typical High $407.38 | Professional | None | $323.59 | $323.59 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $549.54 | Professional | None | $426.58 | $426.58 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,202.26 | Professional | None | $562.34 | $812.83 | $1,202.26 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $524.81 | Facility | None | $478.63 | $478.63 | $524.81 |
United Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $630.96 | Professional | None | $354.81 | $398.11 | $630.96 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $691.83 | Professional | None | $478.63 | $478.63 | $691.83 |
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 $162.18 Median $162.18 Typical High $204.17 | Professional | 52 · Reduced service | $162.18 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $81.28 | Professional | 53 · Discontinued | $64.57 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $61.66 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $40.74 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $40.74 |
Where Maryland sits
The same service costs 3.2 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· 45th of 51
$427
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.