How much rates vary
Facilitymedian $126 · 10th to 90th $56 to $1,862Professionalmedian $155 · 10th to 90th $62 to $427
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 $85.11 Median $2,691.53 Typical High $5,128.61 | Facility | None | $85.11 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $85.11 Typical High $194.98 | Professional | None | $48.98 | $85.11 | $194.98 |
AllWays Health Partners Setting Facility Modifier None Typical Low $75.86 Median $257.04 Typical High $1,862.09 | Facility | None | $75.86 | $257.04 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $69.18 Median $173.78 Typical High $1,000.00 | Professional | None | $69.18 | $173.78 | $1,000.00 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $131.83 | Facility | None | $56.23 | $56.23 | $131.83 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $56.23 Median $147.91 Typical High $275.42 | Professional | None | $56.23 | $147.91 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $125.89 Typical High $181.97 | Facility | None | $53.70 | $125.89 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $309.03 | Professional | None | $67.61 | $154.88 | $309.03 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $72.44 Typical High $3,311.31 | Facility | None | $56.23 | $72.44 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $234.42 | Professional | None | $169.82 | $199.53 | $234.42 |
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 $72.44 Median $158.49 Typical High $380.19 | Professional | None | $72.44 | $158.49 | $380.19 |
Health New England Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $229.09 | Professional | None | $199.53 | $218.78 | $229.09 |
Mass General Brigham Setting Facility Modifier None Typical Low $75.86 Median $257.04 Typical High $1,862.09 | Facility | None | $75.86 | $257.04 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $69.18 Median $173.78 Typical High $1,000.00 | Professional | None | $69.18 | $173.78 | $1,000.00 |
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 $70.79 Median $151.36 Typical High $389.05 | Professional | None | $70.79 | $151.36 | $389.05 |
Well Sense Setting Facility Modifier None Typical Low $51.29 Median $89.13 Typical High $162.18 | Facility | None | $51.29 | $89.13 | $162.18 |
Well Sense Setting Professional Modifier None Typical Low $45.71 Median $54.95 Typical High $93.33 | Professional | None | $45.71 | $54.95 | $93.33 |
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 $24.55 Median $42.66 Typical High $81.28 | Professional | 52 · Reduced service | $24.55 | $42.66 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $16.98 Typical High $32.36 | Professional | 53 · Discontinued | $9.77 | $16.98 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $64.57 Typical High $123.03 | Professional | 54 · Surgery only | $36.31 | $64.57 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $12.88 Typical High $24.55 | Professional | 55 · Aftercare only | $7.24 | $12.88 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $8.51 Typical High $16.22 | Professional | 56 · Pre-op care only | $4.90 | $8.51 | $16.22 |
Where Massachusetts sits
The same service costs 3.2 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· 8th of 51
$155
AK $275KY $85.11
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.