How much rates vary
Facilitymedian $490 · 10th to 90th $72 to $3,311Professionalmedian $195 · 10th to 90th $74 to $1,202
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 $407.38 Median $2,187.76 Typical High $3,630.78 | Facility | None | $407.38 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $117.49 Typical High $190.55 | Professional | None | $50.12 | $117.49 | $190.55 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,096.48 Typical High $3,311.31 | Facility | None | $323.59 | $1,096.48 | $3,311.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $77.62 Median $218.78 Typical High $1,202.26 | Professional | None | $77.62 | $218.78 | $1,202.26 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $67.61 Median $81.28 Typical High $151.36 | Facility | None | $67.61 | $81.28 | $151.36 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $67.61 Median $194.98 Typical High $338.84 | Professional | None | $67.61 | $194.98 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,445.44 | Facility | None | $446.68 | $977.24 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $245.47 Typical High $389.05 | Professional | None | $107.15 | $245.47 | $389.05 |
Fallon Health Setting Facility Modifier None Typical Low $72.44 Median $89.13 Typical High $3,311.31 | Facility | None | $72.44 | $89.13 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $295.12 | Professional | None | $199.53 | $239.88 | $295.12 |
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 $74.13 Median $199.53 Typical High $467.74 | Professional | None | $74.13 | $199.53 | $467.74 |
Health New England Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,905.46 | Facility | None | $1,659.59 | $1,659.59 | $1,905.46 |
Health New England Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,096.48 Typical High $3,311.31 | Facility | None | $323.59 | $1,096.48 | $3,311.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $77.62 Median $218.78 Typical High $1,202.26 | Professional | None | $77.62 | $218.78 | $1,202.26 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,456.54 | Facility | None | $575.44 | $1,380.38 | $6,456.54 |
United Setting Professional Modifier None Typical Low $81.28 Median $186.21 Typical High $446.68 | Professional | None | $81.28 | $186.21 | $446.68 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $128.82 Typical High $489.78 | Facility | None | $60.26 | $128.82 | $489.78 |
Well Sense Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $123.03 | Professional | None | $48.98 | $58.88 | $123.03 |
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 $25.12 Median $58.88 Typical High $93.33 | Professional | 52 · Reduced service | $25.12 | $58.88 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $23.44 Typical High $38.02 | Professional | 53 · Discontinued | $10.00 | $23.44 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $87.10 Typical High $141.25 | Professional | 54 · Surgery only | $38.02 | $87.10 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $17.38 Typical High $28.18 | Professional | 55 · Aftercare only | $7.59 | $17.38 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $11.75 Typical High $19.05 | Professional | 56 · Pre-op care only | $5.01 | $11.75 | $19.05 |
Where Massachusetts sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 15th of 51
$200
AK $437HI $89.13
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.