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 $354.81 Median $354.81 Typical High $436.52 | Professional | None | $354.81 | $354.81 | $436.52 |
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 $363.08 Median $1,096.48 Typical High $4,168.69 | Professional | None | $363.08 | $1,096.48 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,380.38 Typical High $1,380.38 | Facility | None | $676.08 | $1,380.38 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,023.29 | Professional | None | $512.86 | $512.86 | $1,023.29 |
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 $446.68 Median $812.83 Typical High $1,148.15 | Professional | None | $446.68 | $812.83 | $1,148.15 |
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 $363.08 Median $1,096.48 Typical High $4,168.69 | Professional | None | $363.08 | $1,096.48 | $4,168.69 |
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 $316.23 Median $588.84 Typical High $1,737.80 | Professional | None | $316.23 | $588.84 | $1,737.80 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,467.37 | $5,128.61 |
6 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 $218.78 | Professional | 52 · Reduced service | $177.83 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $87.10 | Professional | 53 · Discontinued | $70.79 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $66.07 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $43.65 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $43.65 |
Well Sense Setting Professional Modifier 58 · Staged procedure + 76 · Repeat, same provider Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 58 · Staged procedure + 76 · Repeat, same provider | $1,995.26 | $1,995.26 | $1,995.26 |
Where Massachusetts sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 11th of 51
$631
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.