How much rates vary
Facilitymedian $2,138 · 10th to 90th $324 to $4,677Professionalmedian $3,388 · 10th to 90th $2,138 to $11,482
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 $2,691.53 Median $3,715.35 Typical High $7,413.10 | Facility | None | $2,691.53 | $3,715.35 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $295.12 Median $851.14 Typical High $3,715.35 | Facility | None | $295.12 | $851.14 | $3,715.35 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,398.83 Median $7,244.36 Typical High $11,481.54 | Professional | None | $2,398.83 | $7,244.36 | $11,481.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $2,511.89 Typical High $5,888.44 | Facility | None | $83.18 | $2,511.89 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,511.89 | Professional | None | $2,137.96 | $2,137.96 | $2,511.89 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,862.09 Median $3,467.37 Typical High $5,128.61 | Professional | None | $1,862.09 | $3,467.37 | $5,128.61 |
Mass General Brigham Setting Facility Modifier None Typical Low $295.12 Median $851.14 Typical High $3,715.35 | Facility | None | $295.12 | $851.14 | $3,715.35 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,398.83 Median $7,244.36 Typical High $11,481.54 | Professional | None | $2,398.83 | $7,244.36 | $11,481.54 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $7,244.36 | Professional | None | $2,187.76 | $3,235.94 | $7,244.36 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $4,897.79 | Facility | None | $2,511.89 | $3,630.78 | $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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $229.09 |
Where Massachusetts sits
The same service costs 5.8 times more in California than in Arkansas. 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· 10th of 51
$3,020
CA $6,918AR $1,202
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.