How much rates vary
Facilitymedian $417 · 10th to 90th $135 to $2,818Professionalmedian $195 · 10th to 90th $107 to $794
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 $107.15 Median $107.15 Typical High $316.23 | Professional | None | $107.15 | $107.15 | $316.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $269.15 Median $524.81 Typical High $1,949.84 | Facility | None | $269.15 | $524.81 | $1,949.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $117.49 Median $316.23 Typical High $794.33 | Professional | None | $117.49 | $316.23 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $588.84 Typical High $758.58 | Facility | None | $199.53 | $588.84 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $389.05 | Professional | None | $158.49 | $158.49 | $389.05 |
Fallon Health Setting Facility Modifier None Typical Low $120.23 Median $154.88 Typical High $3,311.31 | Facility | None | $120.23 | $154.88 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $190.55 | Professional | None | $131.83 | $154.88 | $190.55 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $467.74 | Professional | None | $134.90 | $245.47 | $467.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $269.15 Median $524.81 Typical High $1,949.84 | Facility | None | $269.15 | $524.81 | $1,949.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $117.49 Median $316.23 Typical High $794.33 | Professional | None | $117.49 | $316.23 | $794.33 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $467.74 | Professional | None | $125.89 | $177.83 | $467.74 |
Well Sense Setting Facility Modifier None Typical Low $91.20 Median $165.96 Typical High $269.15 | Facility | None | $91.20 | $165.96 | $269.15 |
Well Sense Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $95.50 | Professional | None | $79.43 | $79.43 | $95.50 |
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 $53.70 Median $53.70 Typical High $158.49 | Professional | 52 · Reduced service | $53.70 | $53.70 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $63.10 | Professional | 53 · Discontinued | $21.38 | $21.38 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $234.42 | Professional | 54 · Surgery only | $79.43 | $79.43 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $46.77 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $31.62 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $31.62 |
Where Massachusetts sits
The same service costs 4.4 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· 12th of 51
$245
AK $513NY $117
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.