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 $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 $173.78 Median $181.97 Typical High $181.97 | Professional | None | $173.78 | $181.97 | $181.97 |
AllWays Health Partners Setting Facility Modifier None Typical Low $263.03 Median $549.54 Typical High $2,511.89 | Facility | None | $263.03 | $549.54 | $2,511.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $100.00 Median $467.74 Typical High $2,238.72 | Professional | None | $100.00 | $467.74 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $758.58 Typical High $954.99 | Facility | None | $549.54 | $758.58 | $954.99 |
Fallon Health Setting Facility Modifier None Typical Low $208.93 Median $275.42 Typical High $524.81 | Facility | None | $208.93 | $275.42 | $524.81 |
Fallon Health Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $524.81 | Professional | None | $234.42 | $275.42 | $524.81 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $213.80 Median $457.09 Typical High $660.69 | Professional | None | $213.80 | $457.09 | $660.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $263.03 Median $549.54 Typical High $2,511.89 | Facility | None | $263.03 | $549.54 | $2,511.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $100.00 Median $467.74 Typical High $2,238.72 | Professional | None | $100.00 | $467.74 | $2,238.72 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $186.21 Median $457.09 Typical High $933.25 | Professional | None | $186.21 | $457.09 | $933.25 |
Well Sense Setting Facility Modifier None Typical Low $158.49 Median $331.13 Typical High $4,073.80 | Facility | None | $158.49 | $331.13 | $4,073.80 |
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 $91.20 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
Where Massachusetts sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 19th of 51
$447
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.