How much rates vary
Facilitymedian $50 · 10th to 90th $14 to $2,239Professionalmedian $38 · 10th to 90th $15 to $105
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 $83.18 Median $2,187.76 Typical High $3,630.78 | Facility | None | $83.18 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $25.12 Typical High $54.95 | Professional | None | $10.72 | $25.12 | $54.95 |
AllWays Health Partners Setting Facility Modifier None Typical Low $32.36 Median $134.90 Typical High $1,862.09 | Facility | None | $32.36 | $134.90 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $16.60 Median $39.81 Typical High $245.47 | Professional | None | $16.60 | $39.81 | $245.47 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $32.36 | Facility | None | $13.80 | $13.80 | $32.36 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $13.80 Median $33.11 Typical High $67.61 | Professional | None | $13.80 | $33.11 | $67.61 |
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 $15.14 Median $38.02 Typical High $75.86 | Professional | None | $15.14 | $38.02 | $75.86 |
Fallon Health Setting Facility Modifier None Typical Low $15.14 Median $18.62 Typical High $3,311.31 | Facility | None | $15.14 | $18.62 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $57.54 | Professional | None | $41.69 | $48.98 | $57.54 |
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 $18.62 Median $39.81 Typical High $93.33 | Professional | None | $18.62 | $39.81 | $93.33 |
Health New England Setting Facility Modifier None Typical Low $72.44 Median $100.00 Typical High $117.49 | Facility | None | $72.44 | $100.00 | $117.49 |
Mass General Brigham Setting Facility Modifier None Typical Low $32.36 Median $134.90 Typical High $1,862.09 | Facility | None | $32.36 | $134.90 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $16.60 Median $39.81 Typical High $245.47 | Professional | None | $16.60 | $39.81 | $245.47 |
United Setting Facility Modifier None Typical Low $87.10 Median $524.81 Typical High $2,754.23 | Facility | None | $87.10 | $524.81 | $2,754.23 |
United Setting Professional Modifier None Typical Low $17.38 Median $36.31 Typical High $93.33 | Professional | None | $17.38 | $36.31 | $93.33 |
Well Sense Setting Facility Modifier None Typical Low $12.59 Median $21.38 Typical High $40.74 | Facility | None | $12.59 | $21.38 | $40.74 |
Well Sense Setting Professional Modifier None Typical Low $11.48 Median $13.80 Typical High $26.30 | Professional | None | $11.48 | $13.80 | $26.30 |
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 $5.37 Median $12.59 Typical High $21.88 | Professional | 52 · Reduced service | $5.37 | $12.59 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $5.01 Typical High $8.71 | Professional | 53 · Discontinued | $2.14 | $5.01 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.13 Median $18.62 Typical High $33.11 | Professional | 54 · Surgery only | $8.13 | $18.62 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $3.80 Typical High $6.61 | Professional | 55 · Aftercare only | $1.62 | $3.80 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $2.51 Typical High $4.37 | Professional | 56 · Pre-op care only | $1.07 | $2.51 | $4.37 |
Where Massachusetts sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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
$38.02
AK $83.18NJ $23.99
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.