How much rates vary
Facilitymedian $372 · 10th to 90th $123 to $3,548Professionalmedian $200 · 10th to 90th $126 to $891
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 $338.84 Median $2,818.38 Typical High $5,128.61 | Facility | None | $338.84 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $338.84 | Professional | None | $125.89 | $125.89 | $338.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $91.20 Median $724.44 Typical High $3,548.13 | Facility | None | $91.20 | $724.44 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $128.82 Median $338.84 Typical High $891.25 | Professional | None | $128.82 | $338.84 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $831.76 Typical High $1,000.00 | Facility | None | $676.08 | $831.76 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $331.13 | Professional | None | $169.82 | $169.82 | $331.13 |
Fallon Health Setting Facility Modifier None Typical Low $123.03 Median $154.88 Typical High $3,311.31 | Facility | None | $123.03 | $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 $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $389.05 | Professional | None | $138.04 | $257.04 | $389.05 |
Mass General Brigham Setting Facility Modifier None Typical Low $91.20 Median $724.44 Typical High $3,548.13 | Facility | None | $91.20 | $724.44 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $128.82 Median $338.84 Typical High $891.25 | Professional | None | $128.82 | $338.84 | $891.25 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $501.19 | Professional | None | $141.25 | $190.55 | $501.19 |
Well Sense Setting Facility Modifier None Typical Low $91.20 Median $125.89 Typical High $186.21 | Facility | None | $91.20 | $125.89 | $186.21 |
Well Sense Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | None | $87.10 | $87.10 | $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 $63.10 Median $63.10 Typical High $169.82 | Professional | 52 · Reduced service | $63.10 | $63.10 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $67.61 | Professional | 53 · Discontinued | $25.12 | $25.12 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $257.04 | Professional | 54 · Surgery only | $95.50 | $95.50 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $51.29 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $33.88 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $33.88 |
Where Massachusetts sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 15th of 51
$219
AK $513UT $132
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.