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 $1,000.00 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 $33.88 Median $33.88 Typical High $141.25 | Professional | None | $33.88 | $33.88 | $141.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $45.71 Median $128.82 Typical High $1,862.09 | Facility | None | $45.71 | $128.82 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $47.86 Median $117.49 Typical High $512.86 | Professional | None | $47.86 | $117.49 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $53.70 Typical High $676.08 | Facility | None | $50.12 | $53.70 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $162.18 | Professional | None | $70.79 | $70.79 | $162.18 |
Fallon Health Setting Facility Modifier None Typical Low $47.86 Median $63.10 Typical High $3,311.31 | Facility | None | $47.86 | $63.10 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $74.13 | Professional | None | $52.48 | $61.66 | $74.13 |
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 $56.23 Median $102.33 Typical High $154.88 | Professional | None | $56.23 | $102.33 | $154.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $45.71 Median $128.82 Typical High $1,862.09 | Facility | None | $45.71 | $128.82 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $47.86 Median $117.49 Typical High $512.86 | Professional | None | $47.86 | $117.49 | $512.86 |
United Setting Facility Modifier None Typical Low $123.03 Median $524.81 Typical High $2,754.23 | Facility | None | $123.03 | $524.81 | $2,754.23 |
United Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $204.17 | Professional | None | $54.95 | $75.86 | $204.17 |
Well Sense Setting Facility Modifier None Typical Low $7.94 Median $44.67 Typical High $67.61 | Facility | None | $7.94 | $44.67 | $67.61 |
Well Sense Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $44.67 | Professional | None | $37.15 | $37.15 | $44.67 |
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 $16.98 Median $16.98 Typical High $69.18 | Professional | 52 · Reduced service | $16.98 | $16.98 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $28.18 | Professional | 53 · Discontinued | $6.92 | $6.92 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $25.70 Typical High $104.71 | Professional | 54 · Surgery only | $25.70 | $25.70 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $20.89 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $14.13 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $14.13 |
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· 28th of 51
$77.62
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.