How much rates vary
Facilitymedian $776 · 10th to 90th $269 to $3,631Professionalmedian $661 · 10th to 90th $355 to $2,512
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 $354.81 Median $354.81 Typical High $371.54 | Professional | None | $354.81 | $354.81 | $371.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $275.42 Median $741.31 Typical High $2,511.89 | Facility | None | $275.42 | $741.31 | $2,511.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $426.58 Median $891.25 Typical High $2,511.89 | Professional | None | $426.58 | $891.25 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $741.31 Typical High $954.99 | Facility | None | $524.81 | $741.31 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,202.26 | Professional | None | $549.54 | $549.54 | $1,202.26 |
Fallon Health Setting Facility Modifier None Typical Low $69.18 Median $549.54 Typical High $5,888.44 | Facility | None | $69.18 | $549.54 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $549.54 | Professional | None | $467.74 | $467.74 | $549.54 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $426.58 Median $794.33 Typical High $1,122.02 | Professional | None | $426.58 | $794.33 | $1,122.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $275.42 Median $741.31 Typical High $2,511.89 | Facility | None | $275.42 | $741.31 | $2,511.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $426.58 Median $891.25 Typical High $2,511.89 | Professional | None | $426.58 | $891.25 | $2,511.89 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $354.81 Median $588.84 Typical High $1,071.52 | Professional | None | $354.81 | $588.84 | $1,071.52 |
Well Sense Setting Facility Modifier None Typical Low $263.03 Median $3,090.30 Typical High $4,265.80 | Facility | None | $263.03 | $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 $177.83 Median $177.83 Typical High $186.21 | Professional | 52 · Reduced service | $177.83 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | 53 · Discontinued | $70.79 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $263.03 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $56.23 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $37.15 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $37.15 |
Where Massachusetts sits
The same service costs 4.1 times more in Alaska 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· 8th of 51
$708
AK $1,318KY $324
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.