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 $2,818.38 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $275.42 | Professional | None | $204.17 | $257.04 | $275.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $389.05 Median $1,737.80 Typical High $3,981.07 | Facility | None | $389.05 | $1,737.80 | $3,981.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $263.03 Median $575.44 Typical High $1,348.96 | Professional | None | $263.03 | $575.44 | $1,348.96 |
Fallon Health Setting Facility Modifier None Typical Low $263.03 Median $316.23 Typical High $3,311.31 | Facility | None | $263.03 | $316.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $354.81 | Professional | None | $302.00 | $302.00 | $354.81 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $707.95 | Professional | None | $302.00 | $562.34 | $707.95 |
Health New England Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $389.05 Median $1,737.80 Typical High $3,981.07 | Facility | None | $389.05 | $1,737.80 | $3,981.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $263.03 Median $575.44 Typical High $1,348.96 | Professional | None | $263.03 | $575.44 | $1,348.96 |
Well Sense Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $616.60 | Facility | None | $389.05 | $389.05 | $616.60 |
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 $102.33 Median $128.82 Typical High $138.04 | Professional | 52 · Reduced service | $102.33 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $51.29 Typical High $54.95 | Professional | 53 · Discontinued | $41.69 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $194.98 Typical High $204.17 | Professional | 54 · Surgery only | $154.88 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $38.90 Typical High $40.74 | Professional | 55 · Aftercare only | $30.90 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $25.70 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.42 | $25.70 | $27.54 |
Where Massachusetts sits
The same service costs 25.7 times more in Oklahoma than in Vermont. 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
$437
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.