How much rates vary
Facilitymedian $251 · 10th to 90th $107 to $2,239Professionalmedian $251 · 10th to 90th $145 to $1,202
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 $144.54 Median $144.54 Typical High $524.81 | Professional | None | $144.54 | $144.54 | $524.81 |
AllWays Health Partners Setting Facility Modifier None Typical Low $117.49 Median $436.52 Typical High $1,862.09 | Facility | None | $117.49 | $436.52 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $194.98 Median $467.74 Typical High $1,202.26 | Professional | None | $194.98 | $467.74 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $316.23 Typical High $575.44 | Facility | None | $223.87 | $316.23 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $467.74 | Professional | None | $199.53 | $199.53 | $467.74 |
Fallon Health Setting Facility Modifier None Typical Low $95.50 Median $190.55 Typical High $831.76 | Facility | None | $95.50 | $190.55 | $831.76 |
Fallon Health Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $251.19 | Professional | None | $95.50 | $173.78 | $251.19 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $602.56 | Professional | None | $194.98 | $354.81 | $602.56 |
Mass General Brigham Setting Facility Modifier None Typical Low $117.49 Median $436.52 Typical High $1,862.09 | Facility | None | $117.49 | $436.52 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $194.98 Median $467.74 Typical High $1,202.26 | Professional | None | $194.98 | $467.74 | $1,202.26 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $602.56 | Professional | None | $199.53 | $257.04 | $602.56 |
Well Sense Setting Facility Modifier None Typical Low $117.49 Median $223.87 Typical High $371.54 | Facility | None | $117.49 | $223.87 | $371.54 |
Well Sense Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | None | $199.53 | $199.53 | $239.88 |
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 $72.44 Median $72.44 Typical High $263.03 | Professional | 52 · Reduced service | $72.44 | $72.44 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $104.71 | Professional | 53 · Discontinued | $28.84 | $28.84 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $398.11 | Professional | 54 · Surgery only | $107.15 | $107.15 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $79.43 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $52.48 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $52.48 |
Where Massachusetts sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 23rd of 51
$251
AK $562TX $178
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.