How much rates vary
Facilitymedian $219 · 10th to 90th $52 to $2,570Professionalmedian $170 · 10th to 90th $56 to $447
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 $199.53 Median $2,137.96 Typical High $3,630.78 | Facility | None | $199.53 | $2,137.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $114.82 Typical High $186.21 | Professional | None | $47.86 | $114.82 | $186.21 |
AllWays Health Partners Setting Facility Modifier None Typical Low $125.89 Median $524.81 Typical High $2,454.71 | Facility | None | $125.89 | $524.81 | $2,454.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $61.66 Median $173.78 Typical High $1,122.02 | Professional | None | $61.66 | $173.78 | $1,122.02 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $120.23 | Facility | None | $51.29 | $51.29 | $120.23 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $51.29 Median $117.49 Typical High $316.23 | Professional | None | $51.29 | $117.49 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $218.78 Typical High $954.99 | Facility | None | $154.88 | $218.78 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $177.83 Typical High $354.81 | Professional | None | $61.66 | $177.83 | $354.81 |
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 $194.98 Median $229.09 Typical High $269.15 | Professional | None | $194.98 | $229.09 | $269.15 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $70.79 Median $181.97 Typical High $436.52 | Professional | None | $70.79 | $181.97 | $436.52 |
Health New England Setting Facility Modifier None Typical Low $398.11 Median $575.44 Typical High $977.24 | Facility | None | $398.11 | $575.44 | $977.24 |
Health New England Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $125.89 Median $524.81 Typical High $2,454.71 | Facility | None | $125.89 | $524.81 | $2,454.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $61.66 Median $173.78 Typical High $1,122.02 | Professional | None | $61.66 | $173.78 | $1,122.02 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $70.79 Median $169.82 Typical High $446.68 | Professional | None | $70.79 | $169.82 | $446.68 |
Well Sense Setting Facility Modifier None Typical Low $51.29 Median $97.72 Typical High $190.55 | Facility | None | $51.29 | $97.72 | $190.55 |
Well Sense Setting Professional Modifier None Typical Low $47.86 Median $56.23 Typical High $144.54 | Professional | None | $47.86 | $56.23 | $144.54 |
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 $23.99 Median $38.02 Typical High $61.66 | Professional | 52 · Reduced service | $23.99 | $38.02 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.14 Typical High $24.55 | Professional | 53 · Discontinued | $9.55 | $15.14 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $57.54 Typical High $91.20 | Professional | 54 · Surgery only | $35.48 | $57.54 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.48 Typical High $18.20 | Professional | 55 · Aftercare only | $7.08 | $11.48 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.59 Typical High $12.30 | Professional | 56 · Pre-op care only | $4.79 | $7.59 | $12.30 |
Where Massachusetts sits
The same service costs 2.6 times more in Alaska than in Montana. 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
$170
AK $282MT $107
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.