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 $109.65 Median $109.65 Typical High $181.97 | Professional | None | $109.65 | $109.65 | $181.97 |
AllWays Health Partners Setting Facility Modifier None Typical Low $281.84 Median $1,023.29 Typical High $3,548.13 | Facility | None | $281.84 | $1,023.29 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $138.04 Median $338.84 Typical High $1,862.09 | Professional | None | $138.04 | $338.84 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $416.87 | Professional | None | $154.88 | $199.53 | $416.87 |
Fallon Health Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $3,311.31 | Facility | None | $120.23 | $147.91 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $208.93 | Professional | None | $125.89 | $151.36 | $208.93 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $398.11 | Professional | None | $131.83 | $229.09 | $398.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $281.84 Median $1,023.29 Typical High $3,548.13 | Facility | None | $281.84 | $1,023.29 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $138.04 Median $338.84 Typical High $1,862.09 | Professional | None | $138.04 | $338.84 | $1,862.09 |
United Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $467.74 | Professional | None | $138.04 | $199.53 | $467.74 |
Well Sense Setting Facility Modifier None Typical Low $95.50 Median $131.83 Typical High $194.98 | Facility | None | $95.50 | $131.83 | $194.98 |
Well Sense Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $128.82 | Professional | None | $107.15 | $107.15 | $128.82 |
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 $54.95 Median $54.95 Typical High $91.20 | Professional | 52 · Reduced service | $54.95 | $54.95 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $36.31 | Professional | 53 · Discontinued | $21.88 | $21.88 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $134.90 | Professional | 54 · Surgery only | $83.18 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $26.92 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $18.20 |
Where Massachusetts sits
The same service costs 3.7 times more in Alaska 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· 14th of 51
$214
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.