How much rates vary
Facilitymedian $537 · 10th to 90th $107 to $3,631Professionalmedian $138 · 10th to 90th $71 to $575
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 $2,691.53 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $67.61 | Professional | None | $54.95 | $54.95 | $67.61 |
AllWays Health Partners Setting Facility Modifier None Typical Low $131.83 Median $524.81 Typical High $1,862.09 | Facility | None | $131.83 | $524.81 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $72.44 Median $190.55 Typical High $575.44 | Professional | None | $72.44 | $190.55 | $575.44 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $199.53 | Professional | None | $87.10 | $144.54 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $549.54 Typical High $776.25 | Facility | None | $53.70 | $549.54 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $89.13 Typical High $186.21 | Professional | None | $87.10 | $89.13 | $186.21 |
Fallon Health Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $5,888.44 | Facility | None | $107.15 | $125.89 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | None | $107.15 | $107.15 | $125.89 |
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 $93.33 Median $173.78 Typical High $257.04 | Professional | None | $93.33 | $173.78 | $257.04 |
Mass General Brigham Setting Facility Modifier None Typical Low $131.83 Median $524.81 Typical High $1,862.09 | Facility | None | $131.83 | $524.81 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $72.44 Median $190.55 Typical High $575.44 | Professional | None | $72.44 | $190.55 | $575.44 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,818.38 | Facility | None | $123.03 | $549.54 | $2,818.38 |
United Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $263.03 | Professional | None | $70.79 | $107.15 | $263.03 |
Well Sense Setting Facility Modifier None Typical Low $213.80 Median $3,090.30 Typical High $4,365.16 | Facility | None | $213.80 | $3,090.30 | $4,365.16 |
Well Sense Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $30.90 | Professional | None | $25.70 | $25.70 | $30.90 |
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 $27.54 Median $27.54 Typical High $33.11 | Professional | 52 · Reduced service | $27.54 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $13.18 | Professional | 53 · Discontinued | $10.96 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $48.98 | Professional | 54 · Surgery only | $41.69 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $9.77 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $6.61 |
Where Massachusetts sits
The same service costs 5.5 times more in Arkansas than in Kentucky. 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· 10th of 51
$151
AR $331KY $60.26
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.