How much rates vary
Facilitymedian $1,096 · 10th to 90th $229 to $5,129Professionalmedian $501 · 10th to 90th $257 to $2,399
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 $1,122.02 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,122.02 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $1,122.02 | Professional | None | $363.08 | $363.08 | $1,122.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $371.54 Median $1,862.09 Typical High $5,754.40 | Facility | None | $371.54 | $1,862.09 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $346.74 Median $933.25 Typical High $2,398.83 | Professional | None | $346.74 | $933.25 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $3,467.37 Typical High $5,248.07 | Facility | None | $446.68 | $3,467.37 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,202.26 | Professional | None | $467.74 | $467.74 | $1,202.26 |
Fallon Health Setting Facility Modifier None Typical Low $194.98 Median $380.19 Typical High $1,412.54 | Facility | None | $194.98 | $380.19 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $501.19 | Professional | None | $194.98 | $346.74 | $501.19 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $380.19 Median $691.83 Typical High $1,412.54 | Professional | None | $380.19 | $691.83 | $1,412.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $371.54 Median $1,862.09 Typical High $5,754.40 | Facility | None | $371.54 | $1,862.09 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $346.74 Median $933.25 Typical High $2,398.83 | Professional | None | $346.74 | $933.25 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $11,481.54 | Facility | None | $1,047.13 | $2,344.23 | $11,481.54 |
United Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $1,584.89 | Professional | None | $398.11 | $524.81 | $1,584.89 |
Well Sense Setting Facility Modifier None Typical Low $281.84 Median $512.86 Typical High $1,698.24 | Facility | None | $281.84 | $512.86 | $1,698.24 |
Well Sense Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | None | $281.84 | $281.84 | $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 $181.97 Median $181.97 Typical High $562.34 | Professional | 52 · Reduced service | $181.97 | $181.97 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $223.87 | Professional | 53 · Discontinued | $72.44 | $72.44 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $851.14 | Professional | 54 · Surgery only | $275.42 | $275.42 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $169.82 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $112.20 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $112.20 |
Where Massachusetts sits
The same service costs 7.8 times more in Oklahoma 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· 32nd of 51
$525
OK $2,630NY $339
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.