How much rates vary
Facilitymedian $2,951 · 10th to 90th $851 to $6,607Professionalmedian $1,318 · 10th to 90th $589 to $5,623
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 $2,187.76 Median $3,388.44 Typical High $6,760.83 | Facility | None | $2,187.76 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $741.31 Median $2,398.83 Typical High $6,456.54 | Facility | None | $741.31 | $2,398.83 | $6,456.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $676.08 Median $2,238.72 Typical High $5,623.41 | Professional | None | $676.08 | $2,238.72 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,235.94 Typical High $4,168.69 | Facility | None | $676.08 | $3,235.94 | $4,168.69 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $1,318.26 Typical High $5,888.44 | Facility | None | $83.18 | $1,318.26 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,122.02 | $1,122.02 | $1,318.26 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $758.58 Median $1,621.81 Typical High $2,570.40 | Professional | None | $758.58 | $1,621.81 | $2,570.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $741.31 Median $2,398.83 Typical High $6,456.54 | Facility | None | $741.31 | $2,398.83 | $6,456.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $676.08 Median $2,238.72 Typical High $5,623.41 | Professional | None | $676.08 | $2,238.72 | $5,623.41 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,772.37 | Facility | None | $851.14 | $2,818.38 | $9,772.37 |
United Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $2,238.72 | Professional | None | $645.65 | $870.96 | $2,238.72 |
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 $288.40 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $58.88 |
Where Massachusetts sits
The same service costs 10.2 times more in Texas than in New York. 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· 18th of 51
$1,660
TX $4,074NY $398
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.