How much rates vary
Facilitymedian $525 · 10th to 90th $174 to $3,311Professionalmedian $363 · 10th to 90th $182 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 $128.82 Median $204.17 Typical High $562.34 | Professional | None | $128.82 | $204.17 | $562.34 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $1,096.48 Typical High $3,388.44 | Facility | None | $354.81 | $1,096.48 | $3,388.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $194.98 Median $436.52 Typical High $2,290.87 | Professional | None | $194.98 | $436.52 | $2,290.87 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $162.18 Median $194.98 Typical High $363.08 | Facility | None | $162.18 | $194.98 | $363.08 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $524.81 | Professional | None | $138.04 | $257.04 | $524.81 |
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 $208.93 Median $338.84 Typical High $707.95 | Professional | None | $208.93 | $338.84 | $707.95 |
Fallon Health Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $3,311.31 | Facility | None | $162.18 | $208.93 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $467.74 | Professional | None | $316.23 | $380.19 | $467.74 |
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 $186.21 Median $380.19 Typical High $758.58 | Professional | None | $186.21 | $380.19 | $758.58 |
Health New England Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Health New England Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $1,096.48 Typical High $3,388.44 | Facility | None | $354.81 | $1,096.48 | $3,388.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $194.98 Median $436.52 Typical High $2,290.87 | Professional | None | $194.98 | $436.52 | $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 $218.78 Median $363.08 Typical High $758.58 | Professional | None | $218.78 | $363.08 | $758.58 |
Well Sense Setting Facility Modifier None Typical Low $147.91 Median $257.04 Typical High $524.81 | Facility | None | $147.91 | $257.04 | $524.81 |
Well Sense Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $295.12 | Professional | None | $144.54 | $173.78 | $295.12 |
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 $64.57 Median $102.33 Typical High $281.84 | Professional | 52 · Reduced service | $64.57 | $102.33 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $40.74 Typical High $114.82 | Professional | 53 · Discontinued | $25.70 | $40.74 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $154.88 Typical High $426.58 | Professional | 54 · Surgery only | $97.72 | $154.88 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $30.90 Typical High $85.11 | Professional | 55 · Aftercare only | $19.50 | $30.90 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.42 Typical High $56.23 | Professional | 56 · Pre-op care only | $12.88 | $20.42 | $56.23 |
Where Massachusetts sits
The same service costs 3.1 times more in Alaska than in New York. 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· 14th of 51
$380
AK $794NY $257
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.