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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $97.72 | Professional | None | $67.61 | $67.61 | $97.72 |
AllWays Health Partners Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $1,412.54 | Professional | None | $57.54 | $91.20 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $81.28 | Professional | None | $61.66 | $61.66 | $81.28 |
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 $57.54 Median $128.82 Typical High $144.54 | Professional | None | $57.54 | $128.82 | $144.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $1,412.54 | Professional | None | $57.54 | $91.20 | $1,412.54 |
United Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $144.54 | Professional | None | $48.98 | $74.13 | $144.54 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $128.82 Typical High $194.98 | Facility | None | $93.33 | $128.82 | $194.98 |
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 $33.88 Median $33.88 Typical High $48.98 | Professional | 52 · Reduced service | $33.88 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $19.95 | Professional | 53 · Discontinued | $13.49 | $13.49 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $74.13 | Professional | 54 · Surgery only | $51.29 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $14.79 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $9.77 |
Where Massachusetts sits
The same service costs 2.8 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· 37th of 51
$75.86
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.