How much rates vary
Facilitymedian $87 · 10th to 90th $15 to $1,820Professionalmedian $76 · 10th to 90th $17 to $245
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 $14.79 Median $14.79 Typical High $69.18 | Facility | None | $14.79 | $14.79 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $38.02 Typical High $70.79 | Professional | None | $14.79 | $38.02 | $70.79 |
AllWays Health Partners Setting Facility Modifier None Typical Low $52.48 Median $257.04 Typical High $1,862.09 | Facility | None | $52.48 | $257.04 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $17.38 Median $87.10 Typical High $562.34 | Professional | None | $17.38 | $87.10 | $562.34 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $34.67 | Facility | None | $14.79 | $14.79 | $34.67 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $120.23 Typical High $741.31 | Facility | None | $66.07 | $120.23 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $69.18 Typical High $194.98 | Professional | None | $19.95 | $69.18 | $194.98 |
Fallon Health Setting Facility Modifier None Typical Low $16.22 Median $19.50 Typical High $3,311.31 | Facility | None | $16.22 | $19.50 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $134.90 | Professional | None | $100.00 | $114.82 | $134.90 |
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 $19.50 Median $72.44 Typical High $213.80 | Professional | None | $19.50 | $72.44 | $213.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $52.48 Median $257.04 Typical High $1,862.09 | Facility | None | $52.48 | $257.04 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $17.38 Median $87.10 Typical High $562.34 | Professional | None | $17.38 | $87.10 | $562.34 |
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 $20.89 Median $72.44 Typical High $239.88 | Professional | None | $20.89 | $72.44 | $239.88 |
Well Sense Setting Facility Modifier None Typical Low $14.13 Median $57.54 Typical High $104.71 | Facility | None | $14.13 | $57.54 | $104.71 |
Well Sense Setting Professional Modifier None Typical Low $11.75 Median $15.85 Typical High $67.61 | Professional | None | $11.75 | $15.85 | $67.61 |
4 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 $7.41 Median $28.84 Typical High $34.67 | Professional | 52 · Reduced service | $7.41 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $11.48 Typical High $13.80 | Professional | 53 · Discontinued | $2.95 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $8.71 Typical High $10.47 | Professional | 55 · Aftercare only | $2.19 | $8.71 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $5.75 Typical High $6.92 | Professional | 56 · Pre-op care only | $1.48 | $5.75 | $6.92 |
Where Massachusetts sits
The same service costs 5.9 times more in Iowa 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· 20th of 51
$77.62
IA $117KY $19.95
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.