How much rates vary
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 $2,691.53 Median $3,630.78 Typical High $8,709.64 | Facility | None | $2,691.53 | $3,630.78 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,318.26 Median $10,964.78 Typical High $39,810.72 | Facility | None | $1,318.26 | $10,964.78 | $39,810.72 |
Cigna Setting Facility Modifier None Typical Low $8,128.31 Median $21,877.62 Typical High $24,547.09 | Facility | None | $8,128.31 | $21,877.62 | $24,547.09 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,096.48 Median $3,981.07 Typical High $20,892.96 | Facility | None | $1,096.48 | $3,981.07 | $20,892.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $28,840.32 Median $39,810.72 Typical High $51,286.14 | Professional | None | $28,840.32 | $39,810.72 | $51,286.14 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,318.26 Median $10,964.78 Typical High $39,810.72 | Facility | None | $1,318.26 | $10,964.78 | $39,810.72 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $41,686.94 | Facility | None | $1,258.93 | $4,073.80 | $41,686.94 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,467.37 | $5,128.61 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $575.44 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Where Massachusetts sits
The same service costs 5754.4 times more in Oklahoma than in Maine. 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· 41st of 51
$4,266
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.