How much rates vary
Facilitymedian $832 · 10th to 90th $282 to $5,370Professionalmedian $589 · 10th to 90th $316 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 $2,089.30 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,089.30 | $3,019.95 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $436.52 | Professional | None | $407.38 | $407.38 | $436.52 |
AllWays Health Partners Setting Facility Modifier None Typical Low $977.24 Median $2,041.74 Typical High $5,370.32 | Facility | None | $977.24 | $2,041.74 | $5,370.32 |
AllWays Health Partners Setting Professional Modifier None Typical Low $478.63 Median $1,148.15 Typical High $3,235.94 | Professional | None | $478.63 | $1,148.15 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $11,748.98 Typical High $15,135.61 | Facility | None | $676.08 | $11,748.98 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,548.82 | Professional | None | $602.56 | $602.56 | $1,548.82 |
Fallon Health Setting Facility Modifier None Typical Low $234.42 Median $457.09 Typical High $812.83 | Facility | None | $234.42 | $457.09 | $812.83 |
Fallon Health Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $707.95 | Professional | None | $234.42 | $426.58 | $707.95 |
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 $436.52 Median $794.33 Typical High $1,737.80 | Professional | None | $436.52 | $794.33 | $1,737.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $977.24 Median $2,041.74 Typical High $5,370.32 | Facility | None | $977.24 | $2,041.74 | $5,370.32 |
Mass General Brigham Setting Professional Modifier None Typical Low $478.63 Median $1,148.15 Typical High $3,235.94 | Professional | None | $478.63 | $1,148.15 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $13,182.57 | Facility | None | $1,047.13 | $2,344.23 | $13,182.57 |
United Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $1,737.80 | Professional | None | $436.52 | $588.84 | $1,737.80 |
Well Sense Setting Facility Modifier None Typical Low $323.59 Median $416.87 Typical High $3,019.95 | Facility | None | $323.59 | $416.87 | $3,019.95 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $199.53 Median $199.53 Typical High $218.78 | Professional | 52 · Reduced service | $199.53 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 53 · Discontinued | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $331.13 | Professional | 54 · Surgery only | $302.00 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $43.65 |
Where Massachusetts sits
The same service costs 5.9 times more in Arkansas 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· 37th of 51
$603
AR $1,995NY $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.