How much rates vary
Facilitymedian $407 · 10th to 90th $79 to $2,570Professionalmedian $417 · 10th to 90th $89 to $1,549
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 $64.57 Median $309.03 Typical High $467.74 | Professional | None | $64.57 | $309.03 | $467.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $269.15 Median $741.31 Typical High $2,454.71 | Facility | None | $269.15 | $741.31 | $2,454.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $102.33 Median $446.68 Typical High $2,691.53 | Professional | None | $102.33 | $446.68 | $2,691.53 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $186.21 | Facility | None | $79.43 | $79.43 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $660.69 Typical High $954.99 | Facility | None | $467.74 | $660.69 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $346.74 Typical High $1,000.00 | Professional | None | $123.03 | $346.74 | $1,000.00 |
Fallon Health Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $3,311.31 | Facility | None | $81.28 | $102.33 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $660.69 | Professional | None | $457.09 | $537.03 | $660.69 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $97.72 Median $416.87 Typical High $1,148.15 | Professional | None | $97.72 | $416.87 | $1,148.15 |
Mass General Brigham Setting Facility Modifier None Typical Low $269.15 Median $741.31 Typical High $2,454.71 | Facility | None | $269.15 | $741.31 | $2,454.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $102.33 Median $446.68 Typical High $2,691.53 | Professional | None | $102.33 | $446.68 | $2,691.53 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $109.65 Median $398.11 Typical High $1,348.96 | Professional | None | $109.65 | $398.11 | $1,348.96 |
Well Sense Setting Facility Modifier None Typical Low $69.18 Median $269.15 Typical High $478.63 | Facility | None | $69.18 | $269.15 | $478.63 |
Well Sense Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $338.84 | Professional | None | $70.79 | $85.11 | $338.84 |
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 $32.36 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $32.36 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $12.88 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $47.86 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $9.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $6.46 | $30.90 | $30.90 |
Where Massachusetts sits
The same service costs 7.8 times more in Oklahoma than in Nebraska. 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· 36th of 51
$417
OK $1,148NE $148
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.