How much rates vary
Facilitymedian $100 · 10th to 90th $28 to $2,188Professionalmedian $93 · 10th to 90th $31 to $288
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 $186.21 Median $2,187.76 Typical High $3,630.78 | Facility | None | $186.21 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $51.29 Typical High $128.82 | Professional | None | $21.88 | $51.29 | $128.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $257.04 Typical High $1,862.09 | Facility | None | $50.12 | $257.04 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $37.15 Median $102.33 Typical High $660.69 | Professional | None | $37.15 | $102.33 | $660.69 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $64.57 | Facility | None | $27.54 | $27.54 | $64.57 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $23.44 Median $39.81 Typical High $147.91 | Professional | None | $23.44 | $39.81 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $100.00 Typical High $128.82 | Facility | None | $53.70 | $100.00 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $97.72 Typical High $204.17 | Professional | None | $30.20 | $97.72 | $204.17 |
Fallon Health Setting Facility Modifier None Typical Low $28.18 Median $37.15 Typical High $3,311.31 | Facility | None | $28.18 | $37.15 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $158.49 | Professional | None | $114.82 | $134.90 | $158.49 |
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 $38.02 Median $91.20 Typical High $257.04 | Professional | None | $38.02 | $91.20 | $257.04 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $257.04 Typical High $1,862.09 | Facility | None | $50.12 | $257.04 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $37.15 Median $102.33 Typical High $660.69 | Professional | None | $37.15 | $102.33 | $660.69 |
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 $38.02 Median $79.43 Typical High $257.04 | Professional | None | $38.02 | $79.43 | $257.04 |
Well Sense Setting Facility Modifier None Typical Low $25.12 Median $48.98 Typical High $107.15 | Facility | None | $25.12 | $48.98 | $107.15 |
Well Sense Setting Professional Modifier None Typical Low $28.18 Median $33.88 Typical High $60.26 | Professional | None | $28.18 | $33.88 | $60.26 |
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 $10.96 Median $25.70 Typical High $54.95 | Professional | 52 · Reduced service | $10.96 | $25.70 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $10.23 Typical High $21.88 | Professional | 53 · Discontinued | $4.37 | $10.23 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $38.02 Typical High $81.28 | Professional | 54 · Surgery only | $16.22 | $38.02 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $7.59 Typical High $16.22 | Professional | 55 · Aftercare only | $3.24 | $7.59 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $5.13 Typical High $10.96 | Professional | 56 · Pre-op care only | $2.19 | $5.13 | $10.96 |
Where Massachusetts sits
The same service costs 3.5 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· 11th of 51
$93.33
AK $151KY $43.65
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.