How much rates vary
Facilitymedian $372 · 10th to 90th $151 to $2,754Professionalmedian $537 · 10th to 90th $234 to $1,318
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 $851.14 Median $2,818.38 Typical High $4,677.35 | Facility | None | $851.14 | $2,818.38 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $602.56 | Professional | None | $162.18 | $223.87 | $602.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $138.04 Median $501.19 Typical High $2,398.83 | Facility | None | $138.04 | $501.19 | $2,398.83 |
AllWays Health Partners Setting Professional Modifier None Typical Low $281.84 Median $602.56 Typical High $2,951.21 | Professional | None | $281.84 | $602.56 | $2,951.21 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $575.44 | Facility | None | $251.19 | $251.19 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $446.68 Typical High $954.99 | Facility | None | $338.84 | $446.68 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $933.25 | Professional | None | $281.84 | $426.58 | $933.25 |
Fallon Health Setting Facility Modifier None Typical Low $245.47 Median $316.23 Typical High $3,311.31 | Facility | None | $245.47 | $316.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $707.95 | Professional | None | $512.86 | $602.56 | $707.95 |
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 $281.84 Median $588.84 Typical High $1,122.02 | Professional | None | $281.84 | $588.84 | $1,122.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $138.04 Median $501.19 Typical High $2,398.83 | Facility | None | $138.04 | $501.19 | $2,398.83 |
Mass General Brigham Setting Professional Modifier None Typical Low $281.84 Median $602.56 Typical High $2,951.21 | Professional | None | $281.84 | $602.56 | $2,951.21 |
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 $263.03 Median $478.63 Typical High $1,047.13 | Professional | None | $263.03 | $478.63 | $1,047.13 |
Well Sense Setting Facility Modifier None Typical Low $138.04 Median $288.40 Typical High $436.52 | Facility | None | $138.04 | $288.40 | $436.52 |
Well Sense Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $263.03 | Professional | None | $158.49 | $190.55 | $263.03 |
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 $81.28 Median $112.20 Typical High $302.00 | Professional | 52 · Reduced service | $81.28 | $112.20 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $44.67 Typical High $120.23 | Professional | 53 · Discontinued | $32.36 | $44.67 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $165.96 Typical High $446.68 | Professional | 54 · Surgery only | $120.23 | $165.96 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.11 Typical High $89.13 | Professional | 55 · Aftercare only | $23.99 | $33.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.39 Typical High $60.26 | Professional | 56 · Pre-op care only | $16.22 | $22.39 | $60.26 |
Where Massachusetts sits
The same service costs 4.0 times more in Alaska than in New York. 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
$537
AK $1,023NY $257
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.