How much rates vary
Facilitymedian $123 · 10th to 90th $46 to $4,365Professionalmedian $129 · 10th to 90th $81 to $550
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 $2,818.38 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None (both parts) Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | None (both parts) | $85.11 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 26 · Professional part | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $53.70 Median $56.23 Typical High $56.23 | Professional | TC · Technical part | $53.70 | $56.23 | $56.23 |
AllWays Health Partners Setting Professional Modifier None (both parts) Typical Low $95.50 Median $371.54 Typical High $549.54 | Professional | None (both parts) | $95.50 | $371.54 | $549.54 |
AllWays Health Partners Setting Professional Modifier 26 · Professional part Typical Low $33.88 Median $144.54 Typical High $218.78 | Professional | 26 · Professional part | $33.88 | $144.54 | $218.78 |
AllWays Health Partners Setting Professional Modifier TC · Technical part Typical Low $58.88 Median $239.88 Typical High $338.84 | Professional | TC · Technical part | $58.88 | $239.88 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $72.44 Typical High $89.13 | Facility | None | $67.61 | $72.44 | $89.13 |
Fallon Health Setting Facility Modifier None Typical Low $38.90 Median $77.62 Typical High $2,951.21 | Facility | None | $38.90 | $77.62 | $2,951.21 |
Fallon Health Setting Professional Modifier None (both parts) Typical Low $38.90 Median $66.07 Typical High $123.03 | Professional | None (both parts) | $38.90 | $66.07 | $123.03 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $89.13 Median $151.36 Typical High $245.47 | Professional | None (both parts) | $89.13 | $151.36 | $245.47 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $33.88 Median $58.88 Typical High $91.20 | Professional | 26 · Professional part | $33.88 | $58.88 | $91.20 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $56.23 Median $95.50 Typical High $154.88 | Professional | TC · Technical part | $56.23 | $95.50 | $154.88 |
Mass General Brigham Setting Professional Modifier None (both parts) Typical Low $95.50 Median $371.54 Typical High $549.54 | Professional | None (both parts) | $95.50 | $371.54 | $549.54 |
Mass General Brigham Setting Professional Modifier 26 · Professional part Typical Low $33.88 Median $144.54 Typical High $218.78 | Professional | 26 · Professional part | $33.88 | $144.54 | $218.78 |
Mass General Brigham Setting Professional Modifier TC · Technical part Typical Low $58.88 Median $239.88 Typical High $338.84 | Professional | TC · Technical part | $58.88 | $239.88 | $338.84 |
United Setting Facility Modifier None Typical Low $52.48 Median $97.72 Typical High $147.91 | Facility | None | $52.48 | $97.72 | $147.91 |
United Setting Professional Modifier None (both parts) Typical Low $89.13 Median $128.82 Typical High $257.04 | Professional | None (both parts) | $89.13 | $128.82 | $257.04 |
United Setting Professional Modifier 26 · Professional part Typical Low $31.62 Median $51.29 Typical High $91.20 | Professional | 26 · Professional part | $31.62 | $51.29 | $91.20 |
United Setting Professional Modifier TC · Technical part Typical Low $52.48 Median $81.28 Typical High $165.96 | Professional | TC · Technical part | $52.48 | $81.28 | $165.96 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $4,897.79 | Facility | None | $2,511.89 | $3,630.78 | $4,897.79 |
Well Sense Setting Professional Modifier None (both parts) Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None (both parts) | $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 $41.69 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $41.69 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $16.98 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 54 · Surgery only | $63.10 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $12.59 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.51 | $8.71 | $8.71 |
Where Massachusetts sits
The same service costs 4.4 times more in Texas 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· 6th of 51
$123
TX $174NY $39.81
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.