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 $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $30.20 | Professional | None | $20.42 | $20.42 | $30.20 |
AllWays Health Partners Setting Professional Modifier None Typical Low $16.98 Median $26.92 Typical High $426.58 | Professional | None | $16.98 | $26.92 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $24.55 | Professional | None | $18.20 | $18.20 | $24.55 |
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 Professional Modifier None Typical Low $16.98 Median $38.02 Typical High $42.66 | Professional | None | $16.98 | $38.02 | $42.66 |
Mass General Brigham Setting Professional Modifier None Typical Low $16.98 Median $26.92 Typical High $426.58 | Professional | None | $16.98 | $26.92 | $426.58 |
United Setting Professional Modifier None Typical Low $14.45 Median $21.88 Typical High $42.66 | Professional | None | $14.45 | $21.88 | $42.66 |
Well Sense Setting Facility Modifier None Typical Low $28.18 Median $38.90 Typical High $57.54 | Facility | None | $28.18 | $38.90 | $57.54 |
Well Sense Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $7,762.47 | Professional | None | $6,456.54 | $6,456.54 | $7,762.47 |
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 $10.00 Median $10.00 Typical High $14.79 | Professional | 52 · Reduced service | $10.00 | $10.00 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $6.03 | Professional | 53 · Discontinued | $4.07 | $4.07 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $15.14 Typical High $22.39 | Professional | 54 · Surgery only | $15.14 | $15.14 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $4.47 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $3.02 |
Where Massachusetts sits
The same service costs 2.7 times more in Hawaii 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· 38th of 51
$23.44
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.