How much rates vary
Facilitymedian $617 · 10th to 90th $54 to $3,631Professionalmedian $107 · 10th to 90th $56 to $1,698
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $239.88 | Professional | None | $75.86 | $75.86 | $239.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $4,786.30 | Facility | None | $323.59 | $1,258.93 | $4,786.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $72.44 Median $199.53 Typical High $1,698.24 | Professional | None | $72.44 | $199.53 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,398.83 | Facility | None | $446.68 | $1,659.59 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $263.03 | Professional | None | $100.00 | $100.00 | $263.03 |
Fallon Health Setting Facility Modifier None Typical Low $42.66 Median $85.11 Typical High $1,412.54 | Facility | None | $42.66 | $85.11 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $41.69 Median $74.13 Typical High $107.15 | Professional | None | $41.69 | $74.13 | $107.15 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $275.42 | Professional | None | $81.28 | $147.91 | $275.42 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $4,786.30 | Facility | None | $323.59 | $1,258.93 | $4,786.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $72.44 Median $199.53 Typical High $1,698.24 | Professional | None | $72.44 | $199.53 | $1,698.24 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $8,709.64 | Facility | None | $575.44 | $1,380.38 | $8,709.64 |
United Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $302.00 | Professional | None | $77.62 | $112.20 | $302.00 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $95.50 Typical High $851.14 | Facility | None | $60.26 | $95.50 | $851.14 |
Well Sense Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $70.79 | Professional | None | $58.88 | $58.88 | $70.79 |
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 $38.02 Median $38.02 Typical High $120.23 | Professional | 52 · Reduced service | $38.02 | $38.02 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $47.86 | Professional | 53 · Discontinued | $15.14 | $15.14 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $177.83 | Professional | 54 · Surgery only | $56.23 | $56.23 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $35.48 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $23.99 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $23.99 |
Where Massachusetts sits
The same service costs 11.2 times more in Tennessee 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· 29th of 51
$120
TN $832NY $74.13
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.