How much rates vary
Facilitymedian $2,818 · 10th to 90th $692 to $6,310Professionalmedian $692 · 10th to 90th $398 to $3,311
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 $1,548.82 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,548.82 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | None | $380.19 | $398.11 | $398.11 |
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 $467.74 Median $954.99 Typical High $3,311.31 | Professional | None | $467.74 | $954.99 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,715.35 Typical High $4,786.30 | Facility | None | $676.08 | $3,715.35 | $4,786.30 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $691.83 Typical High $5,888.44 | Facility | None | $83.18 | $691.83 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $691.83 | Professional | None | $588.84 | $588.84 | $691.83 |
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 $489.78 Median $912.01 Typical High $1,348.96 | Professional | None | $489.78 | $912.01 | $1,348.96 |
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 $467.74 Median $954.99 Typical High $3,311.31 | Professional | None | $467.74 | $954.99 | $3,311.31 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $1,584.89 | Professional | None | $416.87 | $549.54 | $1,584.89 |
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 |
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 $186.21 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $186.21 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $75.86 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $281.84 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $56.23 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $39.81 |
Where Massachusetts sits
The same service costs 28.2 times more in Texas 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
$741
TX $2,570KY $91.20
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.