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 $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 $12.59 Median $21.38 Typical High $457.09 | Professional | None | $12.59 | $21.38 | $457.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $23.99 Median $66.07 Typical High $147.91 | Professional | None | $23.99 | $66.07 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $245.47 Typical High $371.54 | Facility | None | $223.87 | $245.47 | $371.54 |
Fallon Health Setting Facility Modifier None Typical Low $28.18 Median $33.11 Typical High $5,888.44 | Facility | None | $28.18 | $33.11 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $33.11 | Professional | None | $28.18 | $28.18 | $33.11 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $23.44 Median $32.36 Typical High $117.49 | Professional | None | $23.44 | $32.36 | $117.49 |
Mass General Brigham Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $23.99 Median $66.07 Typical High $147.91 | Professional | None | $23.99 | $66.07 | $147.91 |
United Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $2,818.38 | Facility | None | $117.49 | $537.03 | $2,818.38 |
United Setting Professional Modifier None Typical Low $22.91 Median $32.36 Typical High $81.28 | Professional | None | $22.91 | $32.36 | $81.28 |
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 $6.31 Median $10.72 Typical High $63.10 | Professional | 52 · Reduced service | $6.31 | $10.72 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $4.27 Typical High $25.12 | Professional | 53 · Discontinued | $2.51 | $4.27 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.33 Median $15.85 Typical High $95.50 | Professional | 54 · Surgery only | $9.33 | $15.85 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $3.24 Typical High $19.05 | Professional | 55 · Aftercare only | $1.91 | $3.24 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $2.14 Typical High $12.59 | Professional | 56 · Pre-op care only | $1.26 | $2.14 | $12.59 |
Where Massachusetts sits
The same service costs 14.5 times more in New Hampshire than in New Jersey. 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· 26th of 51
$42.66
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.