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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $33.88 | Professional | None | $21.88 | $21.88 | $33.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $18.62 Median $28.84 Typical High $660.69 | Professional | None | $18.62 | $28.84 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $26.30 | Professional | None | $19.50 | $19.50 | $26.30 |
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 $18.62 Median $41.69 Typical High $45.71 | Professional | None | $18.62 | $41.69 | $45.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $18.62 Median $28.84 Typical High $660.69 | Professional | None | $18.62 | $28.84 | $660.69 |
United Setting Professional Modifier None Typical Low $15.85 Median $23.44 Typical High $45.71 | Professional | None | $15.85 | $23.44 | $45.71 |
Well Sense Setting Facility Modifier None Typical Low $30.20 Median $41.69 Typical High $61.66 | Facility | None | $30.20 | $41.69 | $61.66 |
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 $10.96 Median $10.96 Typical High $16.98 | Professional | 52 · Reduced service | $10.96 | $10.96 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $6.76 | Professional | 53 · Discontinued | $4.37 | $4.37 | $6.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $16.22 Typical High $25.70 | Professional | 54 · Surgery only | $16.22 | $16.22 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $5.13 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $3.39 |
Where Massachusetts sits
The same service costs 3.2 times more in Rhode Island 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
$25.12
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.