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 $26.30 Median $26.30 Typical High $112.20 | Professional | None | $26.30 | $26.30 | $112.20 |
AllWays Health Partners Setting Facility Modifier None Typical Low $45.71 Median $338.84 Typical High $1,862.09 | Facility | None | $45.71 | $338.84 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $35.48 Median $87.10 Typical High $954.99 | Professional | None | $35.48 | $87.10 | $954.99 |
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 $61.66 Median $61.66 Typical High $138.04 | Professional | None | $61.66 | $61.66 | $138.04 |
Fallon Health Setting Facility Modifier None Typical Low $34.67 Median $46.77 Typical High $3,311.31 | Facility | None | $34.67 | $46.77 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $38.02 Median $44.67 Typical High $53.70 | Professional | None | $38.02 | $44.67 | $53.70 |
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 $39.81 Median $74.13 Typical High $173.78 | Professional | None | $39.81 | $74.13 | $173.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $45.71 Median $338.84 Typical High $1,862.09 | Facility | None | $45.71 | $338.84 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $35.48 Median $87.10 Typical High $954.99 | Professional | None | $35.48 | $87.10 | $954.99 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $173.78 | Professional | None | $44.67 | $61.66 | $173.78 |
Well Sense Setting Facility Modifier None Typical Low $7.94 Median $36.31 Typical High $57.54 | Facility | None | $7.94 | $36.31 | $57.54 |
Well Sense Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $34.67 | Professional | None | $28.84 | $28.84 | $34.67 |
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 $13.18 Median $13.18 Typical High $54.95 | Professional | 52 · Reduced service | $13.18 | $13.18 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $22.39 | Professional | 53 · Discontinued | $5.25 | $5.25 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $19.95 Typical High $83.18 | Professional | 54 · Surgery only | $19.95 | $19.95 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $16.60 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $11.22 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $11.22 |
Where Massachusetts sits
The same service costs 9.3 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· 29th of 51
$66.07
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.