How much rates vary
Facilitymedian $1,175 · 10th to 90th $129 to $5,495Professionalmedian $191 · 10th to 90th $105 to $977
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 $380.19 Median $2,187.76 Typical High $3,630.78 | Facility | None | $380.19 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $354.81 | Professional | None | $81.28 | $81.28 | $354.81 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,949.84 Typical High $5,495.41 | Facility | None | $323.59 | $1,949.84 | $5,495.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $109.65 Median $275.42 Typical High $977.24 | Professional | None | $109.65 | $275.42 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,630.27 Typical High $3,890.45 | Facility | None | $446.68 | $2,630.27 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $416.87 | Professional | None | $186.21 | $186.21 | $416.87 |
Fallon Health Setting Facility Modifier None Typical Low $112.20 Median $147.91 Typical High $3,311.31 | Facility | None | $112.20 | $147.91 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $169.82 | Professional | None | $120.23 | $138.04 | $169.82 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $512.86 | Professional | None | $123.03 | $229.09 | $512.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,949.84 Typical High $5,495.41 | Facility | None | $323.59 | $1,949.84 | $5,495.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $109.65 Median $275.42 Typical High $977.24 | Professional | None | $109.65 | $275.42 | $977.24 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $501.19 | Professional | None | $138.04 | $194.98 | $501.19 |
Well Sense Setting Facility Modifier None Typical Low $95.50 Median $169.82 Typical High $1,148.15 | Facility | None | $95.50 | $169.82 | $1,148.15 |
Well Sense Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | None | $91.20 | $91.20 | $109.65 |
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 $40.74 Median $40.74 Typical High $177.83 | Professional | 52 · Reduced service | $40.74 | $40.74 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $70.79 | Professional | 53 · Discontinued | $16.22 | $16.22 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $263.03 | Professional | 54 · Surgery only | $61.66 | $61.66 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $52.48 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $35.48 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $35.48 |
Where Massachusetts sits
The same service costs 12.9 times more in Arkansas 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· 20th of 51
$263
AR $1,585NY $123
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.