How much rates vary
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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | None | $87.10 | $95.50 | $95.50 |
AllWays Health Partners Setting Professional Modifier None Typical Low $107.15 Median $263.03 Typical High $645.65 | Professional | None | $107.15 | $263.03 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $691.83 Typical High $1,023.29 | Facility | None | $630.96 | $691.83 | $1,023.29 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $144.54 Typical High $5,888.44 | Facility | None | $83.18 | $144.54 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | None | $123.03 | $123.03 | $144.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $263.03 | Professional | None | $104.71 | $194.98 | $263.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $107.15 Median $263.03 Typical High $645.65 | Professional | None | $107.15 | $263.03 | $645.65 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $4,073.80 Typical High $6,165.95 | Facility | None | $2,187.76 | $4,073.80 | $6,165.95 |
United Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $338.84 | Professional | None | $97.72 | $128.82 | $338.84 |
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 Typical Low $2,511.89 Median $2,511.89 Typical High $3,388.44 | Professional | None | $2,511.89 | $2,511.89 | $3,388.44 |
4 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 $43.65 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $43.65 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $17.38 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $12.88 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.71 | $9.55 | $9.55 |
Where Massachusetts sits
The same service costs 3.2 times more in Alaska 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
$162
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.