How much rates vary
Facilitymedian $331 · 10th to 90th $78 to $3,467Professionalmedian $141 · 10th to 90th $72 to $646
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $269.15 | Professional | None | $67.61 | $67.61 | $269.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $57.54 Median $501.19 Typical High $3,548.13 | Facility | None | $57.54 | $501.19 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $85.11 Median $194.98 Typical High $645.65 | Professional | None | $85.11 | $194.98 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $1,380.38 | Facility | None | $50.12 | $954.99 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $269.15 | Professional | None | $95.50 | $109.65 | $269.15 |
Fallon Health Setting Facility Modifier None Typical Low $77.62 Median $95.50 Typical High $3,311.31 | Facility | None | $77.62 | $95.50 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $120.23 | Professional | None | $81.28 | $95.50 | $120.23 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $85.11 Median $151.36 Typical High $218.78 | Professional | None | $85.11 | $151.36 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $57.54 Median $501.19 Typical High $3,548.13 | Facility | None | $57.54 | $501.19 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $85.11 Median $194.98 Typical High $645.65 | Professional | None | $85.11 | $194.98 | $645.65 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $309.03 | Professional | None | $95.50 | $128.82 | $309.03 |
Well Sense Setting Facility Modifier None Typical Low $56.23 Median $79.43 Typical High $117.49 | Facility | None | $56.23 | $79.43 | $117.49 |
Well Sense Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | None | $69.18 | $69.18 | $83.18 |
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 $33.88 Median $33.88 Typical High $134.90 | Professional | 52 · Reduced service | $33.88 | $33.88 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $53.70 | Professional | 53 · Discontinued | $13.49 | $13.49 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $50.12 Typical High $199.53 | Professional | 54 · Surgery only | $50.12 | $50.12 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $40.74 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $26.92 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $26.92 |
Where Massachusetts sits
The same service costs 6.5 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· 18th of 51
$145
TN $513NY $79.43
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.