How much rates vary
Facilitymedian $3,890 · 10th to 90th $676 to $13,183Professionalmedian $457 · 10th to 90th $288 to $1,862
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 $1,318.26 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | None | $269.15 | $288.40 | $288.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $8,709.64 | Facility | None | $891.25 | $3,890.45 | $8,709.64 |
AllWays Health Partners Setting Professional Modifier None Typical Low $338.84 Median $707.95 Typical High $1,862.09 | Professional | None | $338.84 | $707.95 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $19,054.61 Typical High $23,988.33 | Facility | None | $676.08 | $19,054.61 | $23,988.33 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $407.38 Typical High $5,888.44 | Facility | None | $83.18 | $407.38 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | None | $346.74 | $346.74 | $407.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $794.33 | Professional | None | $302.00 | $562.34 | $794.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $8,709.64 | Facility | None | $891.25 | $3,890.45 | $8,709.64 |
Mass General Brigham Setting Professional Modifier None Typical Low $338.84 Median $707.95 Typical High $1,862.09 | Professional | None | $338.84 | $707.95 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $19,054.61 | Facility | None | $1,071.52 | $3,890.45 | $19,054.61 |
United Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $1,148.15 | Professional | None | $295.12 | $407.38 | $1,148.15 |
Well Sense Setting Facility Modifier None Typical Low $3,630.78 Median $5,754.40 Typical High $10,000.00 | Facility | None | $3,630.78 | $5,754.40 | $10,000.00 |
Well Sense Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $7,244.36 | Professional | None | $5,248.07 | $5,248.07 | $7,244.36 |
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 $134.90 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $134.90 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $53.70 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $204.17 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $40.74 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $26.92 | $28.84 | $28.84 |
Where Massachusetts sits
The same service costs 9.5 times more in Arkansas than in Kentucky. 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· 9th of 51
$537
AR $1,905KY $200
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.