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 $371.54 Median $371.54 Typical High $380.19 | Professional | None | $371.54 | $371.54 | $380.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $8,709.64 | Facility | None | $891.25 | $3,890.45 | $8,709.64 |
AllWays Health Partners Setting Professional Modifier None Typical Low $446.68 Median $977.24 Typical High $2,290.87 | Professional | None | $446.68 | $977.24 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $5,623.41 Typical High $7,079.46 | Facility | None | $676.08 | $5,623.41 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $467.74 | Professional | None | $331.13 | $331.13 | $467.74 |
Fallon Health Setting Facility Modifier None Typical Low $398.11 Median $489.78 Typical High $977.24 | Facility | None | $398.11 | $489.78 | $977.24 |
Fallon Health Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $588.84 | Professional | None | $446.68 | $512.86 | $588.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $436.52 Median $794.33 Typical High $1,174.90 | Professional | None | $436.52 | $794.33 | $1,174.90 |
Mass General Brigham Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $8,709.64 | Facility | None | $891.25 | $3,890.45 | $8,709.64 |
Mass General Brigham Setting Professional Modifier None Typical Low $446.68 Median $977.24 Typical High $2,290.87 | Professional | None | $446.68 | $977.24 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,595.87 | Facility | None | $1,071.52 | $3,890.45 | $16,595.87 |
United Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $1,412.54 | Professional | None | $407.38 | $512.86 | $1,412.54 |
Well Sense Setting Facility Modifier None Typical Low $331.13 Median $588.84 Typical High $2,398.83 | Facility | None | $331.13 | $588.84 | $2,398.83 |
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 $181.97 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $288.40 | Professional | 54 · Surgery only | $275.42 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $57.54 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $38.02 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $38.02 |
Where Massachusetts sits
The same service costs 4.5 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
$575
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.