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 $190.55 Median $190.55 Typical High $229.09 | Professional | None | $190.55 | $190.55 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $323.59 | Professional | None | $251.19 | $251.19 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $354.81 | Professional | None | $257.04 | $257.04 | $354.81 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $707.95 | Professional | None | $331.13 | $478.63 | $707.95 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $309.03 | Facility | None | $234.42 | $234.42 | $309.03 |
United Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $371.54 | Professional | None | $208.93 | $229.09 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $398.11 | Professional | None | $275.42 | $275.42 | $398.11 |
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 $95.50 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $95.50 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 53 · Discontinued | $38.02 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $22.91 |
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· 49th of 51
$257
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.