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 $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $19.50 | Professional | None | $15.49 | $15.49 | $19.50 |
AllWays Health Partners Setting Professional Modifier None Typical Low $13.18 Median $20.42 Typical High $275.42 | Professional | None | $13.18 | $20.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $18.62 | Professional | None | $14.13 | $14.13 | $18.62 |
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 $13.18 Median $29.51 Typical High $33.11 | Professional | None | $13.18 | $29.51 | $33.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $13.18 Median $20.42 Typical High $275.42 | Professional | None | $13.18 | $20.42 | $275.42 |
United Setting Professional Modifier None Typical Low $11.22 Median $16.98 Typical High $33.11 | Professional | None | $11.22 | $16.98 | $33.11 |
Well Sense Setting Facility Modifier None Typical Low $21.38 Median $29.51 Typical High $43.65 | Facility | None | $21.38 | $29.51 | $43.65 |
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 $7.76 Median $7.76 Typical High $9.77 | Professional | 52 · Reduced service | $7.76 | $7.76 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.09 Typical High $3.89 | Professional | 53 · Discontinued | $3.09 | $3.09 | $3.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.75 Median $11.75 Typical High $14.79 | Professional | 54 · Surgery only | $11.75 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.34 Typical High $2.95 | Professional | 55 · Aftercare only | $2.34 | $2.34 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.55 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.55 | $1.55 | $1.95 |
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
$17.38
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.