How much rates vary
Facilitymedian $302 · 10th to 90th $132 to $2,399Professionalmedian $355 · 10th to 90th $148 to $2,042
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 $691.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $691.83 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $213.80 Typical High $398.11 | Professional | None | $104.71 | $213.80 | $398.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $162.18 Median $467.74 Typical High $2,041.74 | Facility | None | $162.18 | $467.74 | $2,041.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $169.82 Median $389.05 Typical High $2,041.74 | Professional | None | $169.82 | $389.05 | $2,041.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $131.83 Median $158.49 Typical High $302.00 | Facility | None | $131.83 | $158.49 | $302.00 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $549.54 | Professional | None | $223.87 | $223.87 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $467.74 Typical High $776.25 | Facility | None | $323.59 | $467.74 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $354.81 Typical High $707.95 | Professional | None | $169.82 | $354.81 | $707.95 |
Fallon Health Setting Facility Modifier None Typical Low $131.83 Median $169.82 Typical High $3,311.31 | Facility | None | $131.83 | $169.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $501.19 | Professional | None | $338.84 | $407.38 | $501.19 |
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 $151.36 Median $331.13 Typical High $776.25 | Professional | None | $151.36 | $331.13 | $776.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $162.18 Median $467.74 Typical High $2,041.74 | Facility | None | $162.18 | $467.74 | $2,041.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $169.82 Median $389.05 Typical High $2,041.74 | Professional | None | $169.82 | $389.05 | $2,041.74 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $173.78 Median $354.81 Typical High $831.76 | Professional | None | $173.78 | $354.81 | $831.76 |
Well Sense Setting Facility Modifier None Typical Low $109.65 Median $181.97 Typical High $323.59 | Facility | None | $109.65 | $181.97 | $323.59 |
Well Sense Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $234.42 | Professional | None | $100.00 | $120.23 | $234.42 |
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 $52.48 Median $104.71 Typical High $199.53 | Professional | 52 · Reduced service | $52.48 | $104.71 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $42.66 Typical High $79.43 | Professional | 53 · Discontinued | $20.89 | $42.66 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $158.49 Typical High $295.12 | Professional | 54 · Surgery only | $79.43 | $158.49 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $31.62 Typical High $58.88 | Professional | 55 · Aftercare only | $15.85 | $31.62 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $21.38 Typical High $39.81 | Professional | 56 · Pre-op care only | $10.47 | $21.38 | $39.81 |
Where Massachusetts sits
The same service costs 3.2 times more in Wisconsin 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· 12th of 51
$347
WI $646KY $204
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.