How much rates vary
Facilitymedian $46 · 10th to 90th $17 to $1,862Professionalmedian $48 · 10th to 90th $23 to $135
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 $16.98 Median $29.51 Typical High $141.25 | Facility | None | $16.98 | $29.51 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $29.51 Typical High $104.71 | Professional | None | $16.98 | $29.51 | $104.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $39.81 Median $134.90 Typical High $1,862.09 | Facility | None | $39.81 | $134.90 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $24.55 Median $54.95 Typical High $338.84 | Professional | None | $24.55 | $54.95 | $338.84 |
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 $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $100.00 | Facility | None | $50.12 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $46.77 Typical High $87.10 | Professional | None | $23.44 | $46.77 | $87.10 |
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 $45.71 Median $52.48 Typical High $60.26 | Professional | None | $45.71 | $52.48 | $60.26 |
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 $23.99 Median $47.86 Typical High $97.72 | Professional | None | $23.99 | $47.86 | $97.72 |
Health New England Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Mass General Brigham Setting Facility Modifier None Typical Low $39.81 Median $134.90 Typical High $1,862.09 | Facility | None | $39.81 | $134.90 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $24.55 Median $54.95 Typical High $338.84 | Professional | None | $24.55 | $54.95 | $338.84 |
United Setting Facility Modifier None Typical Low $123.03 Median $524.81 Typical High $2,754.23 | Facility | None | $123.03 | $524.81 | $2,754.23 |
United Setting Professional Modifier None Typical Low $25.70 Median $51.29 Typical High $100.00 | Professional | None | $25.70 | $51.29 | $100.00 |
Well Sense Setting Facility Modifier None Typical Low $16.22 Median $26.92 Typical High $43.65 | Facility | None | $16.22 | $26.92 | $43.65 |
Well Sense Setting Professional Modifier None Typical Low $26.30 Median $35.48 Typical High $42.66 | Professional | None | $26.30 | $35.48 | $42.66 |
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 $8.51 Median $14.79 Typical High $52.48 | Professional | 52 · Reduced service | $8.51 | $14.79 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $5.89 Typical High $20.89 | Professional | 53 · Discontinued | $3.39 | $5.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $4.37 Typical High $15.49 | Professional | 55 · Aftercare only | $2.51 | $4.37 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $2.95 Typical High $10.47 | Professional | 56 · Pre-op care only | $1.70 | $2.95 | $10.47 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $16.60 Median $22.39 Typical High $30.90 | Professional | 78 · Unplanned return to OR | $16.60 | $22.39 | $30.90 |
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· 11th of 51
$47.86
AK $91.20VA $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.