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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $48.98 | Professional | None | $33.88 | $33.88 | $48.98 |
AllWays Health Partners Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $707.95 | Professional | None | $28.84 | $44.67 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $40.74 | Professional | None | $30.90 | $30.90 | $40.74 |
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 $28.84 Median $64.57 Typical High $72.44 | Professional | None | $28.84 | $64.57 | $72.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $707.95 | Professional | None | $28.84 | $44.67 | $707.95 |
United Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $72.44 | Professional | None | $24.55 | $37.15 | $72.44 |
Well Sense Setting Facility Modifier None Typical Low $46.77 Median $64.57 Typical High $97.72 | Facility | None | $46.77 | $64.57 | $97.72 |
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 $16.98 Median $16.98 Typical High $24.55 | Professional | 52 · Reduced service | $16.98 | $16.98 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $10.00 | Professional | 53 · Discontinued | $6.76 | $6.76 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $25.70 Typical High $37.15 | Professional | 54 · Surgery only | $25.70 | $25.70 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $7.41 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $4.90 |
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· 36th of 51
$39.81
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.