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 $169.82 Median $169.82 Typical High $245.47 | Professional | None | $169.82 | $169.82 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $288.40 | Professional | None | $218.78 | $218.78 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $630.96 | Professional | None | $295.12 | $416.87 | $630.96 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $275.42 | Facility | None | $213.80 | $213.80 | $275.42 |
United Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $331.13 | Professional | None | $186.21 | $204.17 | $331.13 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $354.81 | Professional | None | $141.25 | $245.47 | $354.81 |
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 $85.11 Median $85.11 Typical High $107.15 | Professional | 52 · Reduced service | $85.11 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $42.66 | Professional | 53 · Discontinued | $33.88 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $31.62 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $21.38 |
Where Maryland sits
The same service costs 4.7 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
$219
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.