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 $144.54 Median $144.54 Typical High $223.87 | Professional | None | $144.54 | $144.54 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $245.47 | Professional | None | $190.55 | $190.55 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Facility | None | $229.09 | $229.09 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $537.03 | Professional | None | $251.19 | $363.08 | $537.03 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $251.19 | Facility | None | $229.09 | $229.09 | $251.19 |
United Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $281.84 | Professional | None | $154.88 | $177.83 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $309.03 | Professional | None | $199.53 | $204.17 | $309.03 |
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 $72.44 Median $72.44 Typical High $87.10 | Professional | 52 · Reduced service | $72.44 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $34.67 | Professional | 53 · Discontinued | $28.84 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $26.30 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $17.38 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $17.38 |
Where Maryland sits
The same service costs 3.5 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· 43rd of 51
$191
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.