How much rates vary
Facilitymedian $2,754 · 10th to 90th $407 to $11,220Professionalmedian $589 · 10th to 90th $372 to $2,692
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 $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
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 $446.68 Median $1,445.44 Typical High $2,691.53 | Professional | None | $446.68 | $1,445.44 | $2,691.53 |
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 $398.11 Median $501.19 Typical High $977.24 | Facility | None | $398.11 | $501.19 | $977.24 |
Fallon Health Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $588.84 | Professional | None | $407.38 | $501.19 | $588.84 |
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 $398.11 Median $741.31 Typical High $1,445.44 | Professional | None | $398.11 | $741.31 | $1,445.44 |
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 $446.68 Median $1,445.44 Typical High $2,691.53 | Professional | None | $446.68 | $1,445.44 | $2,691.53 |
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 $398.11 Median $562.34 Typical High $1,445.44 | Professional | None | $398.11 | $562.34 | $1,445.44 |
Well Sense Setting Facility Modifier None Typical Low $302.00 Median $2,754.23 Typical High $4,897.79 | Facility | None | $302.00 | $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 $186.21 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Where Massachusetts sits
The same service costs 15.8 times more in Arkansas than in Maine. 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· 30th of 51
$741
AR $6,918ME $437
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.