How much rates vary
Facilitymedian $1,820 · 10th to 90th $501 to $5,129Professionalmedian $776 · 10th to 90th $457 to $2,570
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 $1,548.82 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,548.82 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $4,786.30 | Facility | None | $501.19 | $1,318.26 | $4,786.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $512.86 Median $1,513.56 Typical High $2,570.40 | Professional | None | $512.86 | $1,513.56 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $2,238.72 | Facility | None | $676.08 | $1,737.80 | $2,238.72 |
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 $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $426.58 Median $831.76 Typical High $1,995.26 | Professional | None | $426.58 | $831.76 | $1,995.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $4,786.30 | Facility | None | $501.19 | $1,318.26 | $4,786.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $512.86 Median $1,513.56 Typical High $2,570.40 | Professional | None | $512.86 | $1,513.56 | $2,570.40 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,918.31 | Facility | None | $575.44 | $1,380.38 | $6,918.31 |
United Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $1,513.56 | Professional | None | $467.74 | $707.95 | $1,513.56 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
Where Massachusetts sits
The same service costs 8.1 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
$912
TX $2,291NY $282
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.