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 $37.15 Median $37.15 Typical High $46.77 | Professional | None | $37.15 | $37.15 | $46.77 |
CareFirst Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $63.10 | Professional | None | $51.29 | $51.29 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Facility | None | $56.23 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $138.04 | Professional | None | $64.57 | $93.33 | $138.04 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $72.44 | Professional | None | $38.02 | $45.71 | $72.44 |
Wellpoint Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $79.43 | Professional | None | $50.12 | $50.12 | $79.43 |
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 $18.62 Median $18.62 Typical High $22.39 | Professional | 52 · Reduced service | $18.62 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $8.91 | Professional | 53 · Discontinued | $7.41 | $7.41 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $6.76 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $4.47 |
Where Maryland sits
The same service costs 2.6 times more in Kansas than in Arizona. 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· 40th of 51
$50.12
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.