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 $2,691.53 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $169.82 Median $724.44 Typical High $3,548.13 | Facility | None | $169.82 | $724.44 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $213.80 Median $549.54 Typical High $4,365.16 | Professional | None | $213.80 | $549.54 | $4,365.16 |
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 $426.58 Median $426.58 Typical High $691.83 | Professional | None | $426.58 | $426.58 | $691.83 |
Fallon Health Setting Facility Modifier None Typical Low $245.47 Median $309.03 Typical High $3,311.31 | Facility | None | $245.47 | $309.03 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $407.38 | Professional | None | $257.04 | $309.03 | $407.38 |
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 $223.87 Median $416.87 Typical High $588.84 | Professional | None | $223.87 | $416.87 | $588.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $169.82 Median $724.44 Typical High $3,548.13 | Facility | None | $169.82 | $724.44 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $213.80 Median $549.54 Typical High $4,365.16 | Professional | None | $213.80 | $549.54 | $4,365.16 |
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 $208.93 Median $281.84 Typical High $831.76 | Professional | None | $208.93 | $281.84 | $831.76 |
Well Sense Setting Facility Modifier None Typical Low $158.49 Median $223.87 Typical High $316.23 | Facility | None | $158.49 | $223.87 | $316.23 |
Well Sense Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,584.89 | $2,137.96 |
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 $371.54 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Where Massachusetts sits
The same service costs 8.1 times more in New York than in Missouri. 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· 8th of 51
$457
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.