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 $234.42 Median $234.42 Typical High $295.12 | Professional | None | $234.42 | $234.42 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $398.11 | Professional | None | $302.00 | $302.00 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $870.96 | Professional | None | $407.38 | $575.44 | $870.96 |
United Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $371.54 | Facility | None | $269.15 | $269.15 | $371.54 |
United Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $446.68 | Professional | None | $251.19 | $281.84 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $489.78 | Professional | None | $331.13 | $331.13 | $489.78 |
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 $117.49 Median $117.49 Typical High $147.91 | Professional | 52 · Reduced service | $117.49 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $58.88 | Professional | 53 · Discontinued | $46.77 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $43.65 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $29.51 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $29.51 |
Where Maryland sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 44th of 51
$302
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.