How much rates vary
Facilitymedian $195 · 10th to 90th $85 to $1,862Professionalmedian $219 · 10th to 90th $93 to $589
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 $144.54 Median $2,691.53 Typical High $5,128.61 | Facility | None | $144.54 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $144.54 Typical High $251.19 | Professional | None | $74.13 | $144.54 | $251.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $104.71 Median $389.05 Typical High $1,862.09 | Facility | None | $104.71 | $389.05 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $104.71 Median $245.47 Typical High $1,318.26 | Professional | None | $104.71 | $245.47 | $1,318.26 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $199.53 | Facility | None | $85.11 | $85.11 | $199.53 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $85.11 Median $208.93 Typical High $363.08 | Professional | None | $85.11 | $208.93 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $199.53 Typical High $269.15 | Facility | None | $53.70 | $199.53 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $204.17 Typical High $407.38 | Professional | None | $104.71 | $204.17 | $407.38 |
Fallon Health Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $3,311.31 | Facility | None | $85.11 | $109.65 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $316.23 | Professional | None | $223.87 | $263.03 | $316.23 |
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 $112.20 Median $218.78 Typical High $501.19 | Professional | None | $112.20 | $218.78 | $501.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $104.71 Median $389.05 Typical High $1,862.09 | Facility | None | $104.71 | $389.05 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $104.71 Median $245.47 Typical High $1,318.26 | Professional | None | $104.71 | $245.47 | $1,318.26 |
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 $107.15 Median $218.78 Typical High $512.86 | Professional | None | $107.15 | $218.78 | $512.86 |
Well Sense Setting Facility Modifier None Typical Low $77.62 Median $125.89 Typical High $213.80 | Facility | None | $77.62 | $125.89 | $213.80 |
Well Sense Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $134.90 | Professional | None | $70.79 | $83.18 | $134.90 |
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 $37.15 Median $70.79 Typical High $125.89 | Professional | 52 · Reduced service | $37.15 | $70.79 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $28.84 Typical High $50.12 | Professional | 53 · Discontinued | $14.79 | $28.84 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $107.15 Typical High $186.21 | Professional | 54 · Surgery only | $56.23 | $107.15 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $21.38 Typical High $37.15 | Professional | 55 · Aftercare only | $11.22 | $21.38 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $14.45 Typical High $25.12 | Professional | 56 · Pre-op care only | $7.41 | $14.45 | $25.12 |
Where Massachusetts sits
The same service costs 3.3 times more in Alaska than in Maryland. 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
$214
AK $398MD $120
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.