How much rates vary
Facilitymedian $100 · 10th to 90th $31 to $2,239Professionalmedian $98 · 10th to 90th $32 to $309
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 $75.86 Median $2,691.53 Typical High $5,128.61 | Facility | None | $75.86 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $72.44 Typical High $144.54 | Professional | None | $25.70 | $72.44 | $144.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $295.12 Typical High $1,862.09 | Facility | None | $50.12 | $295.12 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $37.15 Median $117.49 Typical High $724.44 | Professional | None | $37.15 | $117.49 | $724.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $72.44 | Facility | None | $30.90 | $30.90 | $72.44 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $30.90 Median $69.18 Typical High $199.53 | Professional | None | $30.90 | $69.18 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $100.00 | Facility | None | $50.12 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $112.20 Typical High $229.09 | Professional | None | $37.15 | $112.20 | $229.09 |
Fallon Health Setting Facility Modifier None Typical Low $30.90 Median $39.81 Typical High $3,311.31 | Facility | None | $30.90 | $39.81 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $173.78 | Professional | None | $123.03 | $144.54 | $173.78 |
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 $100.00 Typical High $275.42 | Professional | None | $38.02 | $100.00 | $275.42 |
Health New England Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $3,090.30 | Facility | None | $281.84 | $281.84 | $3,090.30 |
Health New England Setting Professional Modifier None Typical Low $72.44 Median $134.90 Typical High $158.49 | Professional | None | $72.44 | $134.90 | $158.49 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $295.12 Typical High $1,862.09 | Facility | None | $50.12 | $295.12 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $37.15 Median $117.49 Typical High $724.44 | Professional | None | $37.15 | $117.49 | $724.44 |
Tufts Setting Professional Modifier None Typical Low $31.62 Median $53.70 Typical High $93.33 | Professional | None | $31.62 | $53.70 | $93.33 |
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 $38.02 Median $93.33 Typical High $288.40 | Professional | None | $38.02 | $93.33 | $288.40 |
Well Sense Setting Facility Modifier None Typical Low $29.51 Median $58.88 Typical High $128.82 | Facility | None | $29.51 | $58.88 | $128.82 |
Well Sense Setting Professional Modifier None Typical Low $21.38 Median $25.70 Typical High $60.26 | Professional | None | $21.38 | $25.70 | $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 $12.88 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $12.88 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $15.14 Typical High $15.49 | Professional | 53 · Discontinued | $5.25 | $15.14 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $57.54 Typical High $57.54 | Professional | 54 · Surgery only | $19.50 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $3.89 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $2.57 | $7.59 | $7.59 |
Where Massachusetts sits
The same service costs 3.3 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
$97.72
AK $170KY $51.29
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.