How much rates vary
Facilitymedian $3,802 · 10th to 90th $692 to $15,488Professionalmedian $1,023 · 10th to 90th $575 to $2,951
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 $2,691.53 Median $3,630.78 Typical High $8,709.64 | Facility | None | $2,691.53 | $3,630.78 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $707.95 Median $1,905.46 Typical High $2,951.21 | Professional | None | $707.95 | $1,905.46 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $22,387.21 Typical High $28,840.32 | Facility | None | $676.08 | $22,387.21 | $28,840.32 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $691.83 Typical High $5,888.44 | Facility | None | $83.18 | $691.83 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $691.83 | Professional | None | $588.84 | $588.84 | $691.83 |
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 $524.81 Median $1,023.29 Typical High $2,754.23 | Professional | None | $524.81 | $1,023.29 | $2,754.23 |
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 $707.95 Median $1,905.46 Typical High $2,951.21 | Professional | None | $707.95 | $1,905.46 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $33,884.42 | Facility | None | $1,258.93 | $4,073.80 | $33,884.42 |
United Setting Professional Modifier None Typical Low $602.56 Median $977.24 Typical High $2,089.30 | Professional | None | $602.56 | $977.24 | $2,089.30 |
Well Sense Setting Facility Modifier None Typical Low $2,754.23 Median $3,630.78 Typical High $5,754.40 | Facility | None | $2,754.23 | $3,630.78 | $5,754.40 |
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 $338.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $67.61 |
Where Massachusetts sits
The same service costs 27.5 times more in Oklahoma than in New York. 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
$1,202
OK $14,454NY $525
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.