How much rates vary
Facilitymedian $3,631 · 10th to 90th $676 to $12,589Professionalmedian $537 · 10th to 90th $56 to $2,512
Distribution of negotiated rates across all payers (price axis is log-scale). 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 Facility Modifier None Typical Low $2,511.89 Median $3,801.89 Typical High $6,918.31 | Facility | None | $2,511.89 | $3,801.89 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,096.48 Median $3,981.07 Typical High $11,220.18 | Facility | None | $1,096.48 | $3,981.07 | $11,220.18 |
AllWays Health Partners Setting Professional Modifier None Typical Low $69.18 Median $1,071.52 Typical High $2,511.89 | Professional | None | $69.18 | $1,071.52 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $10,715.19 Typical High $13,803.84 | Facility | None | $676.08 | $10,715.19 | $13,803.84 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $562.34 Typical High $5,888.44 | Facility | None | $83.18 | $562.34 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | None | $478.63 | $478.63 | $562.34 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,096.48 | $4,073.80 | $14,125.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $81.28 Median $794.33 Typical High $1,380.38 | Professional | None | $81.28 | $794.33 | $1,380.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,096.48 Median $3,981.07 Typical High $11,220.18 | Facility | None | $1,096.48 | $3,981.07 | $11,220.18 |
Mass General Brigham Setting Professional Modifier None Typical Low $69.18 Median $1,071.52 Typical High $2,511.89 | Professional | None | $69.18 | $1,071.52 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $21,877.62 | Facility | None | $1,258.93 | $4,073.80 | $21,877.62 |
United Setting Professional Modifier None Typical Low $61.66 Median $223.87 Typical High $1,096.48 | Professional | None | $61.66 | $223.87 | $1,096.48 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $4,897.79 | Facility | None | $2,511.89 | $3,630.78 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $28.18 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 54 · Surgery only | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.62 |
Where Massachusetts sits
The same service costs 93.3 times more in Oregon 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.
Massachusetts· 26th of 51
$1,000
OR $7,244VT $77.62
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.