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 $81.28 Median $81.28 Typical High $123.03 | Professional | None | $81.28 | $81.28 | $123.03 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | None | $109.65 | $109.65 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $302.00 | Professional | None | $141.25 | $199.53 | $302.00 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $154.88 | Professional | None | $81.28 | $97.72 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $169.82 | Professional | None | $75.86 | $107.15 | $169.82 |
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 $40.74 Median $40.74 Typical High $48.98 | Professional | 52 · Reduced service | $40.74 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $19.50 | Professional | 53 · Discontinued | $16.22 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $14.79 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $9.77 |
Where Maryland sits
The same service costs 2.3 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· 42nd of 51
$107
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.