How much rates vary
Facilitymedian $2,188 · 10th to 90th $851 to $6,918Professionalmedian $1,318 · 10th to 90th $389 to $5,248
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 $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
AllWays Health Partners Setting Facility Modifier None Typical Low $741.31 Median $2,398.83 Typical High $6,456.54 | Facility | None | $741.31 | $2,398.83 | $6,456.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $467.74 Median $2,511.89 Typical High $5,248.07 | Professional | None | $467.74 | $2,511.89 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $7,762.47 Typical High $10,000.00 | Facility | None | $676.08 | $7,762.47 | $10,000.00 |
Fallon Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,995.26 | Facility | None | $1,000.00 | $1,174.90 | $1,995.26 |
Fallon Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,174.90 | $1,513.56 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $549.54 Median $1,819.70 Typical High $3,019.95 | Professional | None | $549.54 | $1,819.70 | $3,019.95 |
Mass General Brigham Setting Facility Modifier None Typical Low $741.31 Median $2,398.83 Typical High $6,456.54 | Facility | None | $741.31 | $2,398.83 | $6,456.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $467.74 Median $2,511.89 Typical High $5,248.07 | Professional | None | $467.74 | $2,511.89 | $5,248.07 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $15,488.17 | Facility | None | $851.14 | $2,818.38 | $15,488.17 |
United Setting Professional Modifier None Typical Low $416.87 Median $1,174.90 Typical High $2,511.89 | Professional | None | $416.87 | $1,174.90 | $2,511.89 |
Well Sense Setting Facility Modifier None Typical Low $776.25 Median $2,754.23 Typical High $4,897.79 | Facility | None | $776.25 | $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 $194.98 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $38.90 |
Where Massachusetts sits
The same service costs 14.8 times more in Texas 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· 20th of 51
$1,445
TX $5,129ME $347
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.