How much rates vary
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 $2,089.30 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,089.30 | $3,019.95 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $177.83 Median $741.31 Typical High $1,288.25 | Professional | None | $177.83 | $741.31 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $758.58 Typical High $1,000.00 | Facility | None | $676.08 | $758.58 | $1,000.00 |
Fallon Health Setting Facility Modifier None Typical Low $181.97 Median $223.87 Typical High $446.68 | Facility | None | $181.97 | $223.87 | $446.68 |
Fallon Health Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $323.59 | Professional | None | $194.98 | $239.88 | $323.59 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $177.83 Median $354.81 Typical High $489.78 | Professional | None | $177.83 | $354.81 | $489.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $177.83 Median $741.31 Typical High $1,288.25 | Professional | None | $177.83 | $741.31 | $1,288.25 |
United Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $2,818.38 | Facility | None | $117.49 | $537.03 | $2,818.38 |
United Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $602.56 | Professional | None | $169.82 | $223.87 | $602.56 |
Well Sense Setting Facility Modifier None Typical Low $138.04 Median $2,951.21 Typical High $4,897.79 | Facility | None | $138.04 | $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 $134.90 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $27.54 |
Where Massachusetts sits
The same service costs 18.6 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· 16th of 51
$302
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.