How much rates vary
Facilitymedian $447 · 10th to 90th $123 to $2,818Professionalmedian $182 · 10th to 90th $100 to $832
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 $85.11 Median $85.11 Typical High $309.03 | Professional | None | $85.11 | $85.11 | $309.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $269.15 Median $676.08 Typical High $2,089.30 | Facility | None | $269.15 | $676.08 | $2,089.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $112.20 Median $302.00 Typical High $831.76 | Professional | None | $112.20 | $302.00 | $831.76 |
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 $151.36 Median $151.36 Typical High $363.08 | Professional | None | $151.36 | $151.36 | $363.08 |
Fallon Health Setting Facility Modifier None Typical Low $107.15 Median $147.91 Typical High $3,311.31 | Facility | None | $107.15 | $147.91 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $181.97 | Professional | None | $123.03 | $147.91 | $181.97 |
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 $128.82 Median $234.42 Typical High $446.68 | Professional | None | $128.82 | $234.42 | $446.68 |
Mass General Brigham Setting Facility Modifier None Typical Low $269.15 Median $676.08 Typical High $2,089.30 | Facility | None | $269.15 | $676.08 | $2,089.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $112.20 Median $302.00 Typical High $831.76 | Professional | None | $112.20 | $302.00 | $831.76 |
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 $120.23 Median $165.96 Typical High $446.68 | Professional | None | $120.23 | $165.96 | $446.68 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $154.88 Typical High $269.15 | Facility | None | $87.10 | $154.88 | $269.15 |
Well Sense Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | None | $89.13 | $89.13 | $104.71 |
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 $42.66 Median $42.66 Typical High $154.88 | Professional | 52 · Reduced service | $42.66 | $42.66 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $61.66 | Professional | 53 · Discontinued | $16.98 | $16.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $234.42 | Professional | 54 · Surgery only | $64.57 | $64.57 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $46.77 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $30.90 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $30.90 |
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· 11th of 51
$234
AK $479NY $110
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.