How much rates vary
Facilitymedian $69 · 10th to 90th $23 to $2,239Professionalmedian $56 · 10th to 90th $26 to $158
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 $117.49 Median $2,187.76 Typical High $3,630.78 | Facility | None | $117.49 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $34.67 Typical High $75.86 | Professional | None | $17.78 | $34.67 | $75.86 |
AllWays Health Partners Setting Facility Modifier None Typical Low $45.71 Median $134.90 Typical High $1,862.09 | Facility | None | $45.71 | $134.90 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $28.18 Median $61.66 Typical High $338.84 | Professional | None | $28.18 | $61.66 | $338.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $53.70 | Facility | None | $22.91 | $22.91 | $53.70 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $19.50 Median $33.88 Typical High $72.44 | Professional | None | $19.50 | $33.88 | $72.44 |
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 $25.12 Median $51.29 Typical High $102.33 | Professional | None | $25.12 | $51.29 | $102.33 |
Fallon Health Setting Facility Modifier None Typical Low $25.70 Median $30.90 Typical High $3,311.31 | Facility | None | $25.70 | $30.90 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $57.54 Median $67.61 Typical High $79.43 | Professional | None | $57.54 | $67.61 | $79.43 |
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 $30.90 Median $60.26 Typical High $128.82 | Professional | None | $30.90 | $60.26 | $128.82 |
Health New England Setting Facility Modifier None Typical Low $100.00 Median $112.20 Typical High $154.88 | Facility | None | $100.00 | $112.20 | $154.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $45.71 Median $134.90 Typical High $1,862.09 | Facility | None | $45.71 | $134.90 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $28.18 Median $61.66 Typical High $338.84 | Professional | None | $28.18 | $61.66 | $338.84 |
Tufts Setting Facility Modifier None Typical Low $89.13 Median $123.03 Typical High $426.58 | Facility | None | $89.13 | $123.03 | $426.58 |
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 $28.84 Median $54.95 Typical High $125.89 | Professional | None | $28.84 | $54.95 | $125.89 |
Well Sense Setting Facility Modifier None Typical Low $17.38 Median $33.88 Typical High $54.95 | Facility | None | $17.38 | $33.88 | $54.95 |
Well Sense Setting Professional Modifier None Typical Low $19.50 Median $23.44 Typical High $37.15 | Professional | None | $19.50 | $23.44 | $37.15 |
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 $8.91 Median $16.98 Typical High $37.15 | Professional | 52 · Reduced service | $8.91 | $16.98 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $6.92 Typical High $15.14 | Professional | 53 · Discontinued | $3.63 | $6.92 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.49 Median $25.70 Typical High $56.23 | Professional | 54 · Surgery only | $13.49 | $25.70 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $5.13 Typical High $11.22 | Professional | 55 · Aftercare only | $2.69 | $5.13 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $3.47 Typical High $7.41 | Professional | 56 · Pre-op care only | $1.82 | $3.47 | $7.41 |
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· 11th of 51
$56.23
AK $120NJ $34.67
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.