How much rates vary
Facilitymedian $832 · 10th to 90th $224 to $4,169Professionalmedian $490 · 10th to 90th $251 to $3,236
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 $1,778.28 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,778.28 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $1,122.02 | Professional | None | $354.81 | $354.81 | $1,122.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $4,265.80 | Facility | None | $512.86 | $1,445.44 | $4,265.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $323.59 Median $851.14 Typical High $3,235.94 | Professional | None | $323.59 | $851.14 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,290.87 Typical High $3,311.31 | Facility | None | $588.84 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,148.15 | Professional | None | $457.09 | $457.09 | $1,148.15 |
Fallon Health Setting Facility Modifier None Typical Low $190.55 Median $371.54 Typical High $2,187.76 | Facility | None | $190.55 | $371.54 | $2,187.76 |
Fallon Health Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $489.78 | Professional | None | $186.21 | $338.84 | $489.78 |
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 $363.08 Median $660.69 Typical High $1,348.96 | Professional | None | $363.08 | $660.69 | $1,348.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $4,265.80 | Facility | None | $512.86 | $1,445.44 | $4,265.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $323.59 Median $851.14 Typical High $3,235.94 | Professional | None | $323.59 | $851.14 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,332.54 | Facility | None | $1,047.13 | $2,344.23 | $9,332.54 |
United Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $1,513.56 | Professional | None | $389.05 | $537.03 | $1,513.56 |
Well Sense Setting Facility Modifier None Typical Low $275.42 Median $489.78 Typical High $691.83 | Facility | None | $275.42 | $489.78 | $691.83 |
Well Sense Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $331.13 | Professional | None | $275.42 | $275.42 | $331.13 |
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 $177.83 Median $177.83 Typical High $562.34 | Professional | 52 · Reduced service | $177.83 | $177.83 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $223.87 | Professional | 53 · Discontinued | $70.79 | $70.79 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $831.76 | Professional | 54 · Surgery only | $263.03 | $263.03 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $169.82 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $112.20 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $112.20 |
Where Massachusetts sits
The same service costs 4.7 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· 30th of 51
$537
AK $1,622NY $347
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.