How much rates vary
Facilitymedian $525 · 10th to 90th $162 to $3,311Professionalmedian $407 · 10th to 90th $178 to $2,291
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 $123.03 Median $239.88 Typical High $467.74 | Professional | None | $123.03 | $239.88 | $467.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $338.84 Median $1,096.48 Typical High $3,388.44 | Facility | None | $338.84 | $1,096.48 | $3,388.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $199.53 Median $457.09 Typical High $2,290.87 | Professional | None | $199.53 | $457.09 | $2,290.87 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $154.88 Median $186.21 Typical High $346.74 | Facility | None | $154.88 | $186.21 | $346.74 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $630.96 | Professional | None | $263.03 | $263.03 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,122.02 Typical High $1,621.81 | Facility | None | $446.68 | $1,122.02 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $407.38 Typical High $794.33 | Professional | None | $204.17 | $407.38 | $794.33 |
Fallon Health Setting Facility Modifier None Typical Low $154.88 Median $199.53 Typical High $3,311.31 | Facility | None | $154.88 | $199.53 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $562.34 | Professional | None | $380.19 | $457.09 | $562.34 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $177.83 Median $389.05 Typical High $891.25 | Professional | None | $177.83 | $389.05 | $891.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $338.84 Median $1,096.48 Typical High $3,388.44 | Facility | None | $338.84 | $1,096.48 | $3,388.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $199.53 Median $457.09 Typical High $2,290.87 | Professional | None | $199.53 | $457.09 | $2,290.87 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,606.93 | Facility | None | $575.44 | $1,380.38 | $6,606.93 |
United Setting Professional Modifier None Typical Low $204.17 Median $407.38 Typical High $933.25 | Professional | None | $204.17 | $407.38 | $933.25 |
Well Sense Setting Facility Modifier None Typical Low $141.25 Median $275.42 Typical High $524.81 | Facility | None | $141.25 | $275.42 | $524.81 |
Well Sense Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $269.15 | Professional | None | $120.23 | $144.54 | $269.15 |
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 $61.66 Median $120.23 Typical High $234.42 | Professional | 52 · Reduced service | $61.66 | $120.23 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $47.86 Typical High $93.33 | Professional | 53 · Discontinued | $25.12 | $47.86 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $181.97 Typical High $354.81 | Professional | 54 · Surgery only | $93.33 | $181.97 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $36.31 Typical High $70.79 | Professional | 55 · Aftercare only | $18.62 | $36.31 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $23.99 Typical High $46.77 | Professional | 56 · Pre-op care only | $12.30 | $23.99 | $46.77 |
Where Massachusetts sits
The same service costs 3.9 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· 17th of 51
$407
AK $933KY $240
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.