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 $1,047.13 Median $2,691.53 Typical High $5,128.61 | Facility | None | $1,047.13 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $575.44 | Professional | None | $363.08 | $363.08 | $575.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $275.42 Median $776.25 Typical High $3,548.13 | Facility | None | $275.42 | $776.25 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $416.87 Median $933.25 Typical High $2,454.71 | Professional | None | $416.87 | $933.25 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $954.99 | Professional | None | $575.44 | $588.84 | $954.99 |
Fallon Health Setting Facility Modifier None Typical Low $371.54 Median $467.74 Typical High $3,311.31 | Facility | None | $371.54 | $467.74 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $645.65 | Professional | None | $407.38 | $478.63 | $645.65 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $416.87 Median $776.25 Typical High $1,071.52 | Professional | None | $416.87 | $776.25 | $1,071.52 |
Mass General Brigham Setting Facility Modifier None Typical Low $275.42 Median $776.25 Typical High $3,548.13 | Facility | None | $275.42 | $776.25 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $416.87 Median $933.25 Typical High $2,454.71 | Professional | None | $416.87 | $933.25 | $2,454.71 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $1,548.82 | Professional | None | $398.11 | $537.03 | $1,548.82 |
Well Sense Setting Facility Modifier None Typical Low $275.42 Median $380.19 Typical High $562.34 | Facility | None | $275.42 | $380.19 | $562.34 |
Well Sense Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
3 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 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | 54 · Surgery only | $275.42 | $275.42 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $51.29 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $51.29 |
Where Massachusetts sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 12th of 51
$646
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.