How much rates vary
Facilitymedian $501 · 10th to 90th $93 to $3,311Professionalmedian $214 · 10th to 90th $100 to $468
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $208.93 | Professional | None | $70.79 | $114.82 | $208.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,174.90 Typical High $3,630.78 | Facility | None | $323.59 | $1,174.90 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $104.71 Median $223.87 Typical High $3,890.45 | Professional | None | $104.71 | $223.87 | $3,890.45 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $218.78 | Facility | None | $93.33 | $93.33 | $218.78 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $93.33 Median $186.21 Typical High $323.59 | Professional | None | $93.33 | $186.21 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $181.97 Typical High $758.58 | Facility | None | $125.89 | $181.97 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $186.21 Typical High $354.81 | Professional | None | $100.00 | $186.21 | $354.81 |
Fallon Health Setting Facility Modifier None Typical Low $93.33 Median $123.03 Typical High $3,311.31 | Facility | None | $93.33 | $123.03 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $281.84 | Professional | None | $204.17 | $239.88 | $281.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $457.09 | Professional | None | $123.03 | $223.87 | $457.09 |
Health New England Setting Facility Modifier None Typical Low $2,951.21 Median $3,311.31 Typical High $3,890.45 | Facility | None | $2,951.21 | $3,311.31 | $3,890.45 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,174.90 Typical High $3,630.78 | Facility | None | $323.59 | $1,174.90 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $104.71 Median $223.87 Typical High $3,890.45 | Professional | None | $104.71 | $223.87 | $3,890.45 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,348.96 Typical High $5,128.61 | Facility | None | $575.44 | $1,348.96 | $5,128.61 |
United Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $446.68 | Professional | None | $114.82 | $208.93 | $446.68 |
Well Sense Setting Facility Modifier None Typical Low $81.28 Median $151.36 Typical High $691.83 | Facility | None | $81.28 | $151.36 | $691.83 |
Well Sense Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $144.54 | Professional | None | $77.62 | $93.33 | $144.54 |
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 $35.48 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $35.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $14.13 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $85.11 Typical High $85.11 | Professional | 54 · Surgery only | $53.70 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $10.72 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.08 | $11.48 | $11.48 |
Where Massachusetts sits
The same service costs 3.2 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
$214
AK $407NJ $129
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.