How much rates vary
Facilitymedian $3,802 · 10th to 90th $741 to $12,303Professionalmedian $1,047 · 10th to 90th $525 to $5,012
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 $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $676.08 Median $2,137.96 Typical High $5,011.87 | Professional | None | $676.08 | $2,137.96 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $10,715.19 Typical High $13,803.84 | Facility | None | $676.08 | $10,715.19 | $13,803.84 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $562.34 Typical High $5,888.44 | Facility | None | $83.18 | $562.34 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | None | $478.63 | $478.63 | $562.34 |
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 $446.68 Median $977.24 Typical High $3,715.35 | Professional | None | $446.68 | $977.24 | $3,715.35 |
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 $676.08 Median $2,137.96 Typical High $5,011.87 | Professional | None | $676.08 | $2,137.96 | $5,011.87 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $21,877.62 | Facility | None | $1,258.93 | $4,073.80 | $21,877.62 |
United Setting Professional Modifier None Typical Low $524.81 Median $1,148.15 Typical High $2,818.38 | Professional | None | $524.81 | $1,148.15 | $2,818.38 |
Well Sense Setting Facility Modifier None Typical Low $2,754.23 Median $3,630.78 Typical High $5,248.07 | Facility | None | $2,754.23 | $3,630.78 | $5,248.07 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Where Massachusetts sits
The same service costs 16.2 times more in Arkansas 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· 35th of 51
$1,288
AR $7,244NY $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.