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 $134.90 | Professional | None | $81.28 | $81.28 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | None | $131.83 | $131.83 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Facility | None | $107.15 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
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 Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $162.18 | Professional | None | $89.13 | $100.00 | $162.18 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $109.65 | Professional | None | $75.86 | $75.86 | $109.65 |
5 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 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Where Maryland sits
The same service costs 2.1 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
$110
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.