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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $22.91 | Professional | None | $16.60 | $16.60 | $22.91 |
AllWays Health Partners Setting Professional Modifier None Typical Low $14.13 Median $21.88 Typical High $323.59 | Professional | None | $14.13 | $21.88 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $19.95 | Professional | None | $15.14 | $15.14 | $19.95 |
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 $14.13 Median $31.62 Typical High $35.48 | Professional | None | $14.13 | $31.62 | $35.48 |
Mass General Brigham Setting Professional Modifier None Typical Low $14.13 Median $21.88 Typical High $323.59 | Professional | None | $14.13 | $21.88 | $323.59 |
United Setting Professional Modifier None Typical Low $12.02 Median $18.20 Typical High $35.48 | Professional | None | $12.02 | $18.20 | $35.48 |
Well Sense Setting Facility Modifier None Typical Low $22.91 Median $31.62 Typical High $47.86 | Facility | None | $22.91 | $31.62 | $47.86 |
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 $8.32 Median $8.32 Typical High $11.48 | Professional | 52 · Reduced service | $8.32 | $8.32 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $4.57 | Professional | 53 · Discontinued | $3.31 | $3.31 | $4.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.59 Median $12.59 Typical High $16.98 | Professional | 54 · Surgery only | $12.59 | $12.59 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $3.47 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.66 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.66 | $1.66 | $2.29 |
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
$18.62
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.