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 $2,089.30 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,089.30 | $3,019.95 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $691.83 | Professional | None | $660.69 | $660.69 | $691.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $524.81 Median $2,089.30 Typical High $6,165.95 | Facility | None | $524.81 | $2,089.30 | $6,165.95 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,570.40 Typical High $3,715.35 | Facility | None | $446.68 | $2,570.40 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Fallon Health Setting Facility Modifier None Typical Low $50.12 Median $2,818.38 Typical High $6,918.31 | Facility | None | $50.12 | $2,818.38 | $6,918.31 |
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 $954.99 Typical High $1,348.96 | Professional | None | $489.78 | $954.99 | $1,348.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $524.81 Median $2,089.30 Typical High $6,165.95 | Facility | None | $524.81 | $2,089.30 | $6,165.95 |
Mass General Brigham Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
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 $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Well Sense Setting Facility Modifier None Typical Low $1,288.25 Median $3,090.30 Typical High $4,365.16 | Facility | None | $1,288.25 | $3,090.30 | $4,365.16 |
Well Sense Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $575.44 | Professional | None | $489.78 | $489.78 | $575.44 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Where Massachusetts sits
The same service costs 74.1 times more in Oklahoma than in Montana. 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· 29th of 51
$1,047
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.