How much rates vary
Facilitymedian $48 · 10th to 90th $17 to $1,820Professionalmedian $46 · 10th to 90th $23 to $126
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 $16.60 Median $28.18 Typical High $147.91 | Facility | None | $16.60 | $28.18 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $28.18 Typical High $112.20 | Professional | None | $16.60 | $28.18 | $112.20 |
AllWays Health Partners Setting Facility Modifier None Typical Low $37.15 Median $257.04 Typical High $1,862.09 | Facility | None | $37.15 | $257.04 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $23.99 Median $50.12 Typical High $346.74 | Professional | None | $23.99 | $50.12 | $346.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $39.81 | Facility | None | $16.98 | $16.98 | $39.81 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $35.48 Typical High $100.00 | Facility | None | $24.55 | $35.48 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $42.66 Typical High $83.18 | Professional | None | $22.91 | $42.66 | $83.18 |
Fallon Health Setting Facility Modifier None Typical Low $18.62 Median $22.91 Typical High $3,311.31 | Facility | None | $18.62 | $22.91 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $40.74 Median $46.77 Typical High $54.95 | Professional | None | $40.74 | $46.77 | $54.95 |
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 $23.44 Median $45.71 Typical High $89.13 | Professional | None | $23.44 | $45.71 | $89.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $37.15 Median $257.04 Typical High $1,862.09 | Facility | None | $37.15 | $257.04 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $23.99 Median $50.12 Typical High $346.74 | Professional | None | $23.99 | $50.12 | $346.74 |
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 $25.12 Median $50.12 Typical High $95.50 | Professional | None | $25.12 | $50.12 | $95.50 |
Well Sense Setting Facility Modifier None Typical Low $15.85 Median $23.44 Typical High $38.02 | Facility | None | $15.85 | $23.44 | $38.02 |
Well Sense Setting Professional Modifier None Typical Low $28.84 Median $38.02 Typical High $45.71 | Professional | None | $28.84 | $38.02 | $45.71 |
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 $8.32 Median $14.13 Typical High $56.23 | Professional | 52 · Reduced service | $8.32 | $14.13 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $5.62 Typical High $22.39 | Professional | 53 · Discontinued | $3.31 | $5.62 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $4.27 Typical High $16.98 | Professional | 55 · Aftercare only | $2.45 | $4.27 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $2.82 Typical High $11.22 | Professional | 56 · Pre-op care only | $1.66 | $2.82 | $11.22 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $18.62 Median $23.99 Typical High $32.36 | Professional | 78 · Unplanned return to OR | $18.62 | $23.99 | $32.36 |
Where Massachusetts sits
The same service costs 3.5 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· 12th of 51
$45.71
AK $83.18VA $23.99
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.