How much rates vary
Facilitymedian $2,818 · 10th to 90th $603 to $6,166Professionalmedian $871 · 10th to 90th $479 to $3,467
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 $2,089.30 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,089.30 | $3,019.95 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $616.60 Median $1,584.89 Typical High $3,467.37 | Professional | None | $616.60 | $1,584.89 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,162.28 Typical High $4,073.80 | Facility | None | $676.08 | $3,162.28 | $4,073.80 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $512.86 Typical High $5,888.44 | Facility | None | $83.18 | $512.86 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $512.86 | Professional | None | $436.52 | $436.52 | $512.86 |
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 $407.38 Median $851.14 Typical High $2,570.40 | Professional | None | $407.38 | $851.14 | $2,570.40 |
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 $616.60 Median $1,584.89 Typical High $3,467.37 | Professional | None | $616.60 | $1,584.89 | $3,467.37 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,772.37 | Facility | None | $851.14 | $2,818.38 | $9,772.37 |
United Setting Professional Modifier None Typical Low $478.63 Median $912.01 Typical High $1,949.84 | Professional | None | $478.63 | $912.01 | $1,949.84 |
Well Sense Setting Facility Modifier None Typical Low $1,548.82 Median $3,090.30 Typical High $4,265.80 | Facility | None | $1,548.82 | $3,090.30 | $4,265.80 |
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 $316.23 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Where Massachusetts sits
The same service costs 10.2 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· 35th of 51
$977
TX $2,692NY $263
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.