How much rates vary
Facilitymedian $93 · 10th to 90th $47 to $2,399Professionalmedian $85 · 10th to 90th $47 to $186
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $46.77 Typical High $87.10 | Professional | None | $38.90 | $46.77 | $87.10 |
AllWays Health Partners Setting Facility Modifier None Typical Low $34.67 Median $323.59 Typical High $2,344.23 | Facility | None | $34.67 | $323.59 | $2,344.23 |
AllWays Health Partners Setting Professional Modifier None Typical Low $45.71 Median $97.72 Typical High $457.09 | Professional | None | $45.71 | $97.72 | $457.09 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $107.15 | Facility | None | $46.77 | $46.77 | $107.15 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $117.49 | Professional | None | $46.77 | $69.18 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $758.58 Typical High $1,000.00 | Facility | None | $676.08 | $758.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $173.78 | Professional | None | $77.62 | $95.50 | $173.78 |
Fallon Health Setting Facility Modifier None Typical Low $47.86 Median $63.10 Typical High $3,311.31 | Facility | None | $47.86 | $63.10 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $104.71 | Professional | None | $72.44 | $85.11 | $104.71 |
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 $52.48 Median $102.33 Typical High $169.82 | Professional | None | $52.48 | $102.33 | $169.82 |
Health New England Setting Facility Modifier None Typical Low $77.62 Median $776.25 Typical High $1,778.28 | Facility | None | $77.62 | $776.25 | $1,778.28 |
Health New England Setting Professional Modifier None Typical Low $51.29 Median $123.03 Typical High $125.89 | Professional | None | $51.29 | $123.03 | $125.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $34.67 Median $323.59 Typical High $2,344.23 | Facility | None | $34.67 | $323.59 | $2,344.23 |
Mass General Brigham Setting Professional Modifier None Typical Low $45.71 Median $97.72 Typical High $457.09 | Professional | None | $45.71 | $97.72 | $457.09 |
United Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $2,818.38 | Facility | None | $117.49 | $537.03 | $2,818.38 |
United Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $173.78 | Professional | None | $60.26 | $85.11 | $173.78 |
Well Sense Setting Facility Modifier None Typical Low $42.66 Median $56.23 Typical High $85.11 | Facility | None | $42.66 | $56.23 | $85.11 |
Well Sense Setting Professional Modifier None Typical Low $38.90 Median $46.77 Typical High $56.23 | Professional | None | $38.90 | $46.77 | $56.23 |
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 $19.50 Median $23.44 Typical High $23.99 | Professional | 52 · Reduced service | $19.50 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $9.33 Typical High $9.55 | Professional | 53 · Discontinued | $7.76 | $9.33 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $35.48 Typical High $35.48 | Professional | 54 · Surgery only | $28.84 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $5.75 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.68 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.89 | $4.68 | $4.79 |
Where Massachusetts sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 16th of 51
$85.11
AK $240KY $50.12
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.