How much rates vary
Facilitymedian $105 · 10th to 90th $51 to $1,862Professionalmedian $110 · 10th to 90th $54 to $269
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 $75.86 Median $2,691.53 Typical High $5,128.61 | Facility | None | $75.86 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $75.86 Typical High $138.04 | Professional | None | $47.86 | $75.86 | $138.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $51.29 Median $257.04 Typical High $1,862.09 | Facility | None | $51.29 | $257.04 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $56.23 Median $125.89 Typical High $616.60 | Professional | None | $56.23 | $125.89 | $616.60 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $125.89 | Facility | None | $53.70 | $53.70 | $125.89 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $169.82 | Professional | None | $53.70 | $97.72 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $100.00 Typical High $117.49 | Facility | None | $53.70 | $100.00 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $190.55 | Professional | None | $67.61 | $109.65 | $190.55 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $69.18 Typical High $3,311.31 | Facility | None | $56.23 | $69.18 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $144.54 | Professional | None | $109.65 | $125.89 | $144.54 |
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 $57.54 Median $120.23 Typical High $234.42 | Professional | None | $57.54 | $120.23 | $234.42 |
Health New England Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Mass General Brigham Setting Facility Modifier None Typical Low $51.29 Median $257.04 Typical High $1,862.09 | Facility | None | $51.29 | $257.04 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $56.23 Median $125.89 Typical High $616.60 | Professional | None | $56.23 | $125.89 | $616.60 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $58.88 Median $104.71 Typical High $234.42 | Professional | None | $58.88 | $104.71 | $234.42 |
Well Sense Setting Facility Modifier None Typical Low $41.69 Median $60.26 Typical High $93.33 | Facility | None | $41.69 | $60.26 | $93.33 |
Well Sense Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $61.66 | Professional | None | $35.48 | $47.86 | $61.66 |
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 $23.99 Median $38.02 Typical High $69.18 | Professional | 52 · Reduced service | $23.99 | $38.02 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.14 Typical High $27.54 | Professional | 53 · Discontinued | $9.55 | $15.14 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $56.23 Typical High $102.33 | Professional | 54 · Surgery only | $35.48 | $56.23 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.22 Typical High $20.42 | Professional | 55 · Aftercare only | $7.08 | $11.22 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.59 Typical High $13.80 | Professional | 56 · Pre-op care only | $4.79 | $7.59 | $13.80 |
Where Massachusetts sits
The same service costs 3.6 times more in Alaska 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· 9th of 51
$110
AK $204KY $56.23
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.