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 $1,778.28 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 $269.15 Median $269.15 Typical High $851.14 | Professional | None | $269.15 | $269.15 | $851.14 |
AllWays Health Partners Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $5,888.44 | Facility | None | $512.86 | $2,041.74 | $5,888.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $263.03 Median $691.83 Typical High $1,905.46 | Professional | None | $263.03 | $691.83 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,691.53 Typical High $3,311.31 | Facility | None | $676.08 | $2,691.53 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $891.25 | Professional | None | $346.74 | $346.74 | $891.25 |
Fallon Health Setting Facility Modifier None Typical Low $144.54 Median $288.40 Typical High $1,412.54 | Facility | None | $144.54 | $288.40 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $141.25 Median $257.04 Typical High $371.54 | Professional | None | $141.25 | $257.04 | $371.54 |
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 $281.84 Median $512.86 Typical High $1,047.13 | Professional | None | $281.84 | $512.86 | $1,047.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $5,888.44 | Facility | None | $512.86 | $2,041.74 | $5,888.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $263.03 Median $691.83 Typical High $1,905.46 | Professional | None | $263.03 | $691.83 | $1,905.46 |
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 $295.12 Median $398.11 Typical High $1,174.90 | Professional | None | $295.12 | $398.11 | $1,174.90 |
Well Sense Setting Facility Modifier None Typical Low $190.55 Median $323.59 Typical High $1,174.90 | Facility | None | $190.55 | $323.59 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | None | $208.93 | $208.93 | $251.19 |
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 $204.17 Median $204.17 Typical High $630.96 | Professional | 54 · Surgery only | $204.17 | $204.17 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $125.89 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $85.11 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $85.11 |
Where Massachusetts sits
The same service costs 7.2 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· 30th of 51
$417
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.