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 $4,073.80 Median $4,073.80 Typical High $4,073.80 | Facility | None | $4,073.80 | $4,073.80 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $21,877.62 | Professional | None | $4,168.69 | $4,168.69 | $21,877.62 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $8,511.38 Typical High $17,782.79 | Facility | None | $5,248.07 | $8,511.38 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
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 $2,951.21 Median $2,951.21 Typical High $4,168.69 | Professional | None | $2,951.21 | $2,951.21 | $4,168.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $21,877.62 | Professional | None | $4,168.69 | $4,168.69 | $21,877.62 |
United Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,677.35 | Professional | None | $4,168.69 | $4,168.69 | $4,677.35 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,467.37 | $5,128.61 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
4 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 $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $2,041.74 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $407.38 |
Where Massachusetts sits
The same service costs 2.2 times more in Alaska than in South Carolina. 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· 7th of 51
$4,169
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.