How much rates vary
Facilitymedian $603 · 10th to 90th $302 to $3,548Professionalmedian $646 · 10th to 90th $363 to $2,818
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 $288.40 Median $288.40 Typical High $457.09 | Professional | None | $288.40 | $288.40 | $457.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $309.03 Median $794.33 Typical High $3,630.78 | Facility | None | $309.03 | $794.33 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $407.38 Median $977.24 Typical High $2,818.38 | Professional | None | $407.38 | $977.24 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,122.02 | Professional | None | $630.96 | $630.96 | $1,122.02 |
Fallon Health Setting Facility Modifier None Typical Low $426.58 Median $524.81 Typical High $3,311.31 | Facility | None | $426.58 | $524.81 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $630.96 | Professional | None | $446.68 | $524.81 | $630.96 |
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 $467.74 Median $851.14 Typical High $1,288.25 | Professional | None | $467.74 | $851.14 | $1,288.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $309.03 Median $794.33 Typical High $3,630.78 | Facility | None | $309.03 | $794.33 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $407.38 Median $977.24 Typical High $2,818.38 | Professional | None | $407.38 | $977.24 | $2,818.38 |
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 $512.86 Median $707.95 Typical High $1,819.70 | Professional | None | $512.86 | $707.95 | $1,819.70 |
Well Sense Setting Facility Modifier None Typical Low $302.00 Median $371.54 Typical High $588.84 | Facility | None | $302.00 | $371.54 | $588.84 |
Well Sense Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $363.08 | Professional | None | $302.00 | $302.00 | $363.08 |
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 $144.54 Median $144.54 Typical High $229.09 | Professional | 52 · Reduced service | $144.54 | $144.54 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $93.33 | Professional | 53 · Discontinued | $57.54 | $57.54 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $346.74 | Professional | 54 · Surgery only | $213.80 | $213.80 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $69.18 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $45.71 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $45.71 |
Where Massachusetts sits
The same service costs 4.1 times more in Wisconsin than in Kentucky. 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· 30th of 51
$631
WI $1,738KY $427
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.