How much rates vary
Facilitymedian $120 · 10th to 90th $50 to $2,138Professionalmedian $135 · 10th to 90th $56 to $479
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 $380.19 Median $2,187.76 Typical High $3,630.78 | Facility | None | $380.19 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $114.82 Typical High $177.83 | Professional | None | $51.29 | $114.82 | $177.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $52.48 Median $389.05 Typical High $1,819.70 | Facility | None | $52.48 | $389.05 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $64.57 Median $158.49 Typical High $758.58 | Professional | None | $64.57 | $158.49 | $758.58 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $117.49 | Facility | None | $50.12 | $50.12 | $117.49 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $50.12 Median $117.49 Typical High $218.78 | Professional | None | $50.12 | $117.49 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $100.00 Typical High $123.03 | Facility | None | $53.70 | $100.00 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $165.96 Typical High $251.19 | Professional | None | $87.10 | $165.96 | $251.19 |
Fallon Health Setting Facility Modifier None Typical Low $51.29 Median $67.61 Typical High $3,311.31 | Facility | None | $51.29 | $67.61 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $181.97 | Professional | None | $123.03 | $147.91 | $181.97 |
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 $61.66 Median $131.83 Typical High $288.40 | Professional | None | $61.66 | $131.83 | $288.40 |
Health New England Setting Facility Modifier None Typical Low $144.54 Median $181.97 Typical High $676.08 | Facility | None | $144.54 | $181.97 | $676.08 |
Health New England Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $52.48 Median $389.05 Typical High $1,819.70 | Facility | None | $52.48 | $389.05 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $64.57 Median $158.49 Typical High $758.58 | Professional | None | $64.57 | $158.49 | $758.58 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $70.79 Median $141.25 Typical High $309.03 | Professional | None | $70.79 | $141.25 | $309.03 |
Well Sense Setting Facility Modifier None Typical Low $47.86 Median $70.79 Typical High $123.03 | Facility | None | $47.86 | $70.79 | $123.03 |
Well Sense Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $125.89 | Professional | None | $50.12 | $60.26 | $125.89 |
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 $25.70 Median $57.54 Typical High $89.13 | Professional | 52 · Reduced service | $25.70 | $57.54 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $23.44 Typical High $35.48 | Professional | 53 · Discontinued | $10.23 | $23.44 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $87.10 Typical High $134.90 | Professional | 54 · Surgery only | $38.02 | $87.10 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $17.38 Typical High $26.92 | Professional | 55 · Aftercare only | $7.59 | $17.38 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $11.48 Typical High $17.78 | Professional | 56 · Pre-op care only | $5.13 | $11.48 | $17.78 |
Where Massachusetts sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 14th of 51
$132
AK $257PA $93.33
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.