How much rates vary
Facilitymedian $110 · 10th to 90th $68 to $2,818Professionalmedian $224 · 10th to 90th $69 to $891
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 $223.87 Median $2,137.96 Typical High $3,630.78 | Facility | None | $223.87 | $2,137.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $154.88 Typical High $239.88 | Professional | None | $69.18 | $154.88 | $239.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $158.49 Median $1,023.29 Typical High $3,548.13 | Facility | None | $158.49 | $1,023.29 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $83.18 Median $302.00 Typical High $2,630.27 | Professional | None | $83.18 | $302.00 | $2,630.27 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $158.49 | Facility | None | $67.61 | $67.61 | $158.49 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $67.61 Median $223.87 Typical High $223.87 | Professional | None | $67.61 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $234.42 Typical High $457.09 | Professional | None | $91.20 | $234.42 | $457.09 |
Fallon Health Setting Facility Modifier None Typical Low $67.61 Median $83.18 Typical High $3,311.31 | Facility | None | $67.61 | $83.18 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $389.05 | Professional | None | $229.09 | $281.84 | $389.05 |
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 $77.62 Median $229.09 Typical High $549.54 | Professional | None | $77.62 | $229.09 | $549.54 |
Health New England Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $407.38 | Facility | None | $371.54 | $371.54 | $407.38 |
Health New England Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $245.47 | Professional | None | $120.23 | $120.23 | $245.47 |
Mass General Brigham Setting Facility Modifier None Typical Low $158.49 Median $1,023.29 Typical High $3,548.13 | Facility | None | $158.49 | $1,023.29 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $83.18 Median $302.00 Typical High $2,630.27 | Professional | None | $83.18 | $302.00 | $2,630.27 |
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 $87.10 Median $229.09 Typical High $616.60 | Professional | None | $87.10 | $229.09 | $616.60 |
Well Sense Setting Facility Modifier None Typical Low $63.10 Median $123.03 Typical High $251.19 | Facility | None | $63.10 | $123.03 | $251.19 |
Well Sense Setting Professional Modifier None Typical Low $56.23 Median $67.61 Typical High $151.36 | Professional | None | $56.23 | $67.61 | $151.36 |
6 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 $34.67 Median $77.62 Typical High $102.33 | Professional | 52 · Reduced service | $34.67 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $30.90 Typical High $41.69 | Professional | 53 · Discontinued | $13.80 | $30.90 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $117.49 Typical High $154.88 | Professional | 54 · Surgery only | $51.29 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $23.44 Typical High $30.90 | Professional | 55 · Aftercare only | $10.23 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $15.49 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.92 | $15.49 | $20.42 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $38.02 Typical High $75.86 | Professional | 52 · Reduced service | $33.88 | $38.02 | $75.86 |
Where Massachusetts sits
The same service costs 3.8 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· 8th of 51
$224
AK $363VA $95.50
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.