How much rates vary
Facilitymedian $2,754 · 10th to 90th $468 to $11,220Professionalmedian $661 · 10th to 90th $363 to $3,162
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 $1,949.84 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,235.94 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,096.48 Median $3,981.07 Typical High $11,220.18 | Facility | None | $1,096.48 | $3,981.07 | $11,220.18 |
AllWays Health Partners Setting Professional Modifier None Typical Low $436.52 Median $1,412.54 Typical High $3,162.28 | Professional | None | $436.52 | $1,412.54 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $11,481.54 Typical High $14,791.08 | Facility | None | $676.08 | $11,481.54 | $14,791.08 |
Fallon Health Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $1,122.02 | Facility | None | $457.09 | $588.84 | $1,122.02 |
Fallon Health Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $707.95 | Professional | None | $467.74 | $602.56 | $707.95 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,096.48 | $4,073.80 | $14,125.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $436.52 Median $851.14 Typical High $1,412.54 | Professional | None | $436.52 | $851.14 | $1,412.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,096.48 Median $3,981.07 Typical High $11,220.18 | Facility | None | $1,096.48 | $3,981.07 | $11,220.18 |
Mass General Brigham Setting Professional Modifier None Typical Low $436.52 Median $1,412.54 Typical High $3,162.28 | Professional | None | $436.52 | $1,412.54 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $25,703.96 | Facility | None | $1,258.93 | $4,073.80 | $25,703.96 |
United Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $1,412.54 | Professional | None | $389.05 | $602.56 | $1,412.54 |
Well Sense Setting Facility Modifier None Typical Low $338.84 Median $2,754.23 Typical High $4,897.79 | Facility | None | $338.84 | $2,754.23 | $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 $181.97 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $36.31 |
Where Massachusetts sits
The same service costs 16.2 times more in Arkansas than in West Virginia. 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
$813
AR $6,918WV $427
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.