How much rates vary
Facilitymedian $83 · 10th to 90th $46 to $2,818Professionalmedian $182 · 10th to 90th $47 to $724
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 $125.89 Median $1,905.46 Typical High $3,388.44 | Facility | None | $125.89 | $1,905.46 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $125.89 Typical High $199.53 | Professional | None | $46.77 | $125.89 | $199.53 |
AllWays Health Partners Setting Facility Modifier None Typical Low $107.15 Median $1,023.29 Typical High $3,548.13 | Facility | None | $107.15 | $1,023.29 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $54.95 Median $223.87 Typical High $1,862.09 | Professional | None | $54.95 | $223.87 | $1,862.09 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $107.15 | Facility | None | $45.71 | $45.71 | $107.15 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $45.71 Median $190.55 Typical High $190.55 | Professional | None | $45.71 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $181.97 Typical High $363.08 | Professional | None | $63.10 | $181.97 | $363.08 |
Fallon Health Setting Facility Modifier None Typical Low $46.77 Median $57.54 Typical High $3,311.31 | Facility | None | $46.77 | $57.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $331.13 | Professional | None | $194.98 | $234.42 | $331.13 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $52.48 Median $173.78 Typical High $467.74 | Professional | None | $52.48 | $173.78 | $467.74 |
Health New England Setting Facility Modifier None Typical Low $117.49 Median $331.13 Typical High $478.63 | Facility | None | $117.49 | $331.13 | $478.63 |
Health New England Setting Professional Modifier None Typical Low $75.86 Median $158.49 Typical High $398.11 | Professional | None | $75.86 | $158.49 | $398.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $107.15 Median $1,023.29 Typical High $3,548.13 | Facility | None | $107.15 | $1,023.29 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $54.95 Median $223.87 Typical High $1,862.09 | Professional | None | $54.95 | $223.87 | $1,862.09 |
United Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $60.26 Median $181.97 Typical High $501.19 | Professional | None | $60.26 | $181.97 | $501.19 |
Well Sense Setting Facility Modifier None Typical Low $42.66 Median $85.11 Typical High $208.93 | Facility | None | $42.66 | $85.11 | $208.93 |
Well Sense Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $138.04 | Professional | None | $38.02 | $45.71 | $138.04 |
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 $23.44 Median $63.10 Typical High $83.18 | Professional | 52 · Reduced service | $23.44 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $9.33 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $95.50 Typical High $125.89 | Professional | 54 · Surgery only | $34.67 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $19.05 Typical High $25.12 | Professional | 55 · Aftercare only | $7.08 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $12.59 Typical High $16.60 | Professional | 56 · Pre-op care only | $4.68 | $12.59 | $16.60 |
Where Massachusetts sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 9th of 51
$182
AK $257VA $66.07
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.