How much rates vary
Facilitymedian $2,344 · 10th to 90th $275 to $6,166Professionalmedian $380 · 10th to 90th $263 to $1,862
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 $1,318.26 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $794.33 Median $3,388.44 Typical High $7,585.78 | Facility | None | $794.33 | $3,388.44 | $7,585.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $281.84 Median $724.44 Typical High $1,862.09 | Professional | None | $281.84 | $724.44 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,290.87 Typical High $2,884.03 | Facility | None | $676.08 | $2,290.87 | $2,884.03 |
Fallon Health Setting Facility Modifier None Typical Low $257.04 Median $338.84 Typical High $630.96 | Facility | None | $257.04 | $338.84 | $630.96 |
Fallon Health Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $407.38 | Professional | None | $275.42 | $338.84 | $407.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $263.03 Median $489.78 Typical High $812.83 | Professional | None | $263.03 | $489.78 | $812.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $794.33 Median $3,388.44 Typical High $7,585.78 | Facility | None | $794.33 | $3,388.44 | $7,585.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $281.84 Median $724.44 Typical High $1,862.09 | Professional | None | $281.84 | $724.44 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $10,000.00 | Facility | None | $1,071.52 | $3,467.37 | $10,000.00 |
United Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $954.99 | Professional | None | $245.47 | $354.81 | $954.99 |
Well Sense Setting Facility Modifier None Typical Low $194.98 Median $2,951.21 Typical High $4,897.79 | Facility | None | $194.98 | $2,951.21 | $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 $158.49 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Where Massachusetts sits
The same service costs 19.5 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
$447
TX $1,778NY $91.20
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.