How much rates vary
Facilitymedian $126 · 10th to 90th $76 to $2,818Professionalmedian $355 · 10th to 90th $87 to $2,818
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 $234.42 Median $2,137.96 Typical High $3,630.78 | Facility | None | $234.42 | $2,137.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $234.42 Typical High $323.59 | Professional | None | $75.86 | $234.42 | $323.59 |
AllWays Health Partners Setting Facility Modifier None Typical Low $177.83 Median $1,023.29 Typical High $3,548.13 | Facility | None | $177.83 | $1,023.29 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $93.33 Median $446.68 Typical High $2,818.38 | Professional | None | $93.33 | $446.68 | $2,818.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $177.83 | Facility | None | $75.86 | $75.86 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $295.12 Typical High $691.83 | Professional | None | $104.71 | $295.12 | $691.83 |
Fallon Health Setting Facility Modifier None Typical Low $77.62 Median $95.50 Typical High $3,311.31 | Facility | None | $77.62 | $95.50 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $691.83 | Professional | None | $407.38 | $489.78 | $691.83 |
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 $87.10 Median $331.13 Typical High $912.01 | Professional | None | $87.10 | $331.13 | $912.01 |
Health New England Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
Health New England Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Mass General Brigham Setting Facility Modifier None Typical Low $177.83 Median $1,023.29 Typical High $3,548.13 | Facility | None | $177.83 | $1,023.29 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $93.33 Median $446.68 Typical High $2,818.38 | Professional | None | $93.33 | $446.68 | $2,818.38 |
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 $97.72 Median $338.84 Typical High $954.99 | Professional | None | $97.72 | $338.84 | $954.99 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $141.25 Typical High $416.87 | Facility | None | $70.79 | $141.25 | $416.87 |
Well Sense Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $208.93 | Professional | None | $58.88 | $70.79 | $208.93 |
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 $38.02 Median $117.49 Typical High $141.25 | Professional | 52 · Reduced service | $38.02 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $46.77 Typical High $56.23 | Professional | 53 · Discontinued | $15.14 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $177.83 Typical High $208.93 | Professional | 54 · Surgery only | $56.23 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $35.48 Typical High $41.69 | Professional | 55 · Aftercare only | $11.22 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $23.44 Typical High $28.18 | Professional | 56 · Pre-op care only | $7.59 | $23.44 | $28.18 |
Where Massachusetts sits
The same service costs 4.2 times more in Washington 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· 6th of 51
$347
WA $447VA $107
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.