How much rates vary
Facilitymedian $162 · 10th to 90th $62 to $2,951Professionalmedian $155 · 10th to 90th $85 to $398
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 $1,318.26 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $87.10 Median $524.81 Typical High $2,818.38 | Facility | None | $87.10 | $524.81 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $83.18 Median $154.88 Typical High $758.58 | Professional | None | $83.18 | $154.88 | $758.58 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $144.54 | Facility | None | $61.66 | $61.66 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $104.71 Typical High $831.76 | Facility | None | $72.44 | $104.71 | $831.76 |
Fallon Health Setting Facility Modifier None Typical Low $63.10 Median $77.62 Typical High $154.88 | Facility | None | $63.10 | $77.62 | $154.88 |
Fallon Health Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $177.83 | Professional | None | $128.82 | $151.36 | $177.83 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $288.40 | Professional | None | $81.28 | $151.36 | $288.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $87.10 Median $524.81 Typical High $2,818.38 | Facility | None | $87.10 | $524.81 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $83.18 Median $154.88 Typical High $758.58 | Professional | None | $83.18 | $154.88 | $758.58 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $77.62 Median $141.25 Typical High $275.42 | Professional | None | $77.62 | $141.25 | $275.42 |
Well Sense Setting Facility Modifier None Typical Low $81.28 Median $2,754.23 Typical High $4,897.79 | Facility | None | $81.28 | $2,754.23 | $4,897.79 |
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 |
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 $199.53 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $39.81 |
Where Massachusetts sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 6th of 51
$155
AK $263VA $77.62
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.