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 $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 $794.33 Median $3,467.37 Typical High $7,244.36 | Facility | None | $794.33 | $3,467.37 | $7,244.36 |
AllWays Health Partners Setting Professional Modifier None Typical Low $501.19 Median $1,621.81 Typical High $2,454.71 | Professional | None | $501.19 | $1,621.81 | $2,454.71 |
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 $467.74 Median $549.54 Typical High $1,148.15 | Facility | None | $467.74 | $549.54 | $1,148.15 |
Fallon Health Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $812.83 | Professional | None | $467.74 | $549.54 | $812.83 |
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 $478.63 Median $912.01 Typical High $1,318.26 | Professional | None | $478.63 | $912.01 | $1,318.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $7,244.36 | Facility | None | $794.33 | $3,467.37 | $7,244.36 |
Mass General Brigham Setting Professional Modifier None Typical Low $501.19 Median $1,621.81 Typical High $2,454.71 | Professional | None | $501.19 | $1,621.81 | $2,454.71 |
United Setting Facility Modifier None Typical Low $870.96 Median $3,467.37 Typical High $10,232.93 | Facility | None | $870.96 | $3,467.37 | $10,232.93 |
United Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $1,445.44 | Professional | None | $371.54 | $575.44 | $1,445.44 |
Well Sense Setting Facility Modifier None Typical Low $302.00 Median $416.87 Typical High $602.56 | Facility | None | $302.00 | $416.87 | $602.56 |
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 $295.12 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $89.13 |
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 7.8 times more in Texas than in Delaware. 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· 25th of 51
$759
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.