How much rates vary
Facilitymedian $166 · 10th to 90th $66 to $2,570Professionalmedian $269 · 10th to 90th $79 to $813
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 $64.57 Median $199.53 Typical High $229.09 | Professional | None | $64.57 | $199.53 | $229.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $52.48 Median $501.19 Typical High $2,818.38 | Facility | None | $52.48 | $501.19 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $85.11 Median $281.84 Typical High $1,737.80 | Professional | None | $85.11 | $281.84 | $1,737.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $165.96 | Facility | None | $70.79 | $70.79 | $165.96 |
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 $109.65 Median $309.03 Typical High $676.08 | Professional | None | $109.65 | $309.03 | $676.08 |
Fallon Health Setting Facility Modifier None Typical Low $72.44 Median $91.20 Typical High $3,311.31 | Facility | None | $72.44 | $91.20 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $436.52 | Professional | None | $288.40 | $354.81 | $436.52 |
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 $83.18 Median $263.03 Typical High $660.69 | Professional | None | $83.18 | $263.03 | $660.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $52.48 Median $501.19 Typical High $2,818.38 | Facility | None | $52.48 | $501.19 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $85.11 Median $281.84 Typical High $1,737.80 | Professional | None | $85.11 | $281.84 | $1,737.80 |
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 $95.50 Median $281.84 Typical High $724.44 | Professional | None | $95.50 | $281.84 | $724.44 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $120.23 Typical High $302.00 | Facility | None | $60.26 | $120.23 | $302.00 |
Well Sense Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $269.15 | Professional | None | $64.57 | $77.62 | $269.15 |
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 $32.36 Median $97.72 Typical High $114.82 | Professional | 52 · Reduced service | $32.36 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $39.81 Typical High $45.71 | Professional | 53 · Discontinued | $12.88 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $147.91 Typical High $173.78 | Professional | 54 · Surgery only | $47.86 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $29.51 Typical High $34.67 | Professional | 55 · Aftercare only | $9.77 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $19.95 Typical High $22.91 | Professional | 56 · Pre-op care only | $6.46 | $19.95 | $22.91 |
Where Massachusetts sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 21st of 51
$257
OK $575NE $129
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.