How much rates vary
Facilitymedian $912 · 10th to 90th $407 to $3,548Professionalmedian $1,122 · 10th to 90th $562 to $4,898
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 $2,691.53 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $812.83 | Professional | None | $478.63 | $478.63 | $812.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $794.33 Typical High $3,630.78 | Facility | None | $316.23 | $794.33 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $645.65 Median $1,737.80 Typical High $4,897.79 | Professional | None | $645.65 | $1,737.80 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $758.58 Typical High $1,000.00 | Facility | None | $676.08 | $758.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,096.48 | $1,949.84 |
Fallon Health Setting Facility Modifier None Typical Low $741.31 Median $912.01 Typical High $3,311.31 | Facility | None | $741.31 | $912.01 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,096.48 | Professional | None | $776.25 | $912.01 | $1,096.48 |
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 $812.83 Median $1,479.11 Typical High $2,238.72 | Professional | None | $812.83 | $1,479.11 | $2,238.72 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $794.33 Typical High $3,630.78 | Facility | None | $316.23 | $794.33 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $645.65 Median $1,737.80 Typical High $4,897.79 | Professional | None | $645.65 | $1,737.80 | $4,897.79 |
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 $891.25 Median $1,230.27 Typical High $3,162.28 | Professional | None | $891.25 | $1,230.27 | $3,162.28 |
Well Sense Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $1,071.52 | Facility | None | $524.81 | $724.44 | $1,071.52 |
Well Sense Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | None | $562.34 | $562.34 | $676.08 |
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 $239.88 Median $239.88 Typical High $407.38 | Professional | 52 · Reduced service | $239.88 | $239.88 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $162.18 | Professional | 53 · Discontinued | $95.50 | $95.50 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $616.60 | Professional | 54 · Surgery only | $363.08 | $363.08 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $123.03 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $81.28 |
Where Massachusetts sits
The same service costs 3.8 times more in Wisconsin 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· 29th of 51
$1,072
WI $2,951NY $776
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.