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 $11.22 Median $11.22 Typical High $13.80 | Professional | None | $11.22 | $11.22 | $13.80 |
CareFirst Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $19.50 | Professional | None | $15.49 | $15.49 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $15.85 | Professional | None | $11.48 | $11.48 | $15.85 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.95 Median $28.18 Typical High $42.66 | Professional | None | $19.95 | $28.18 | $42.66 |
United Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $11.48 Median $13.80 Typical High $21.88 | Professional | None | $11.48 | $13.80 | $21.88 |
Wellpoint Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $23.99 | Professional | None | $15.14 | $15.14 | $23.99 |
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 $5.62 Median $5.62 Typical High $6.92 | Professional | 52 · Reduced service | $5.62 | $5.62 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.75 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $2.04 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.38 |
Where Maryland sits
The same service costs 5.5 times more in Kansas 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· 38th of 51
$15.14
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.