How much rates vary
Facilitymedian $2,188 · 10th to 90th $214 to $6,761Professionalmedian $309 · 10th to 90th $178 to $1,349
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 $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $208.93 | Professional | None | $165.96 | $165.96 | $208.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $190.55 Median $467.74 Typical High $1,348.96 | Professional | None | $190.55 | $467.74 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,495.41 Typical High $6,760.83 | Facility | None | $741.31 | $5,495.41 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $616.60 | Professional | None | $239.88 | $269.15 | $616.60 |
Fallon Health Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $3,311.31 | Facility | None | $199.53 | $245.47 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $309.03 | Professional | None | $208.93 | $245.47 | $309.03 |
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 $213.80 Median $407.38 Typical High $794.33 | Professional | None | $213.80 | $407.38 | $794.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $190.55 Median $467.74 Typical High $1,348.96 | Professional | None | $190.55 | $467.74 | $1,348.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $11,481.54 | Facility | None | $851.14 | $2,818.38 | $11,481.54 |
United Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $794.33 | Professional | None | $239.88 | $331.13 | $794.33 |
Well Sense Setting Facility Modifier None Typical Low $144.54 Median $199.53 Typical High $295.12 | Facility | None | $144.54 | $199.53 | $295.12 |
Well Sense Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $218.78 | Professional | None | $181.97 | $181.97 | $218.78 |
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 $83.18 Median $83.18 Typical High $104.71 | Professional | 52 · Reduced service | $83.18 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $41.69 | Professional | 53 · Discontinued | $33.11 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $158.49 | Professional | 54 · Surgery only | $125.89 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $31.62 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $20.89 |
Where Massachusetts sits
The same service costs 6.9 times more in Tennessee than in New York. 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· 21st of 51
$372
TN $1,413NY $204
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.