How much rates vary
Facilitymedian $93 · 10th to 90th $35 to $4,365Professionalmedian $93 · 10th to 90th $58 to $427
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 $57.54 Median $58.88 Typical High $58.88 | Professional | None (both parts) | $57.54 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 26 · Professional part | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $36.31 Median $38.02 Typical High $38.02 | Professional | TC · Technical part | $36.31 | $38.02 | $38.02 |
AllWays Health Partners Setting Professional Modifier None (both parts) Typical Low $64.57 Median $251.19 Typical High $426.58 | Professional | None (both parts) | $64.57 | $251.19 | $426.58 |
AllWays Health Partners Setting Professional Modifier 26 · Professional part Typical Low $22.91 Median $97.72 Typical High $169.82 | Professional | 26 · Professional part | $22.91 | $97.72 | $169.82 |
AllWays Health Partners Setting Professional Modifier TC · Technical part Typical Low $42.66 Median $177.83 Typical High $251.19 | Professional | TC · Technical part | $42.66 | $177.83 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $57.54 Typical High $89.13 | Facility | None | $52.48 | $57.54 | $89.13 |
Fallon Health Setting Facility Modifier None Typical Low $30.20 Median $57.54 Typical High $2,951.21 | Facility | None | $30.20 | $57.54 | $2,951.21 |
Fallon Health Setting Professional Modifier None (both parts) Typical Low $30.20 Median $48.98 Typical High $93.33 | Professional | None (both parts) | $30.20 | $48.98 | $93.33 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $61.66 Median $104.71 Typical High $173.78 | Professional | None (both parts) | $61.66 | $104.71 | $173.78 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $23.99 Median $42.66 Typical High $61.66 | Professional | 26 · Professional part | $23.99 | $42.66 | $61.66 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $41.69 Median $72.44 Typical High $112.20 | Professional | TC · Technical part | $41.69 | $72.44 | $112.20 |
Mass General Brigham Setting Professional Modifier None (both parts) Typical Low $64.57 Median $251.19 Typical High $426.58 | Professional | None (both parts) | $64.57 | $251.19 | $426.58 |
Mass General Brigham Setting Professional Modifier 26 · Professional part Typical Low $22.91 Median $97.72 Typical High $169.82 | Professional | 26 · Professional part | $22.91 | $97.72 | $169.82 |
Mass General Brigham Setting Professional Modifier TC · Technical part Typical Low $42.66 Median $177.83 Typical High $251.19 | Professional | TC · Technical part | $42.66 | $177.83 | $251.19 |
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 $61.66 Median $91.20 Typical High $181.97 | Professional | None (both parts) | $61.66 | $91.20 | $181.97 |
United Setting Professional Modifier 26 · Professional part Typical Low $21.38 Median $33.11 Typical High $67.61 | Professional | 26 · Professional part | $21.38 | $33.11 | $67.61 |
United Setting Professional Modifier TC · Technical part Typical Low $38.90 Median $61.66 Typical High $114.82 | Professional | TC · Technical part | $38.90 | $61.66 | $114.82 |
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 $28.84 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $28.84 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.48 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | 54 · Surgery only | $42.66 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.75 | $5.89 | $5.89 |
Where Massachusetts sits
The same service costs 3.3 times more in Nebraska 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· 4th of 51
$93.33
NE $112NY $33.88
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.