How much rates vary
Facilitymedian $240 · 10th to 90th $102 to $2,344Professionalmedian $275 · 10th to 90th $129 to $1,122
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 $645.65 Median $2,691.53 Typical High $3,715.35 | Facility | None | $645.65 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $398.11 | Professional | None | $109.65 | $165.96 | $398.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $102.33 Median $478.63 Typical High $1,862.09 | Facility | None | $102.33 | $478.63 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $144.54 Median $323.59 Typical High $1,862.09 | Professional | None | $144.54 | $323.59 | $1,862.09 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $275.42 | Facility | None | $117.49 | $117.49 | $275.42 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $100.00 Median $194.98 Typical High $389.05 | Professional | None | $100.00 | $194.98 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $239.88 Typical High $489.78 | Facility | None | $100.00 | $239.88 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $549.54 | Professional | None | $151.36 | $257.04 | $549.54 |
Fallon Health Setting Facility Modifier None Typical Low $114.82 Median $151.36 Typical High $3,311.31 | Facility | None | $114.82 | $151.36 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $354.81 | Professional | None | $239.88 | $288.40 | $354.81 |
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 $134.90 Median $281.84 Typical High $588.84 | Professional | None | $134.90 | $281.84 | $588.84 |
Health New England Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,000.00 | Facility | None | $977.24 | $977.24 | $1,000.00 |
Health New England Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $371.54 | Professional | None | $288.40 | $288.40 | $371.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $102.33 Median $478.63 Typical High $1,862.09 | Facility | None | $102.33 | $478.63 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $144.54 Median $323.59 Typical High $1,862.09 | Professional | None | $144.54 | $323.59 | $1,862.09 |
Tufts Setting Facility Modifier None Typical Low $117.49 Median $645.65 Typical High $1,174.90 | Facility | None | $117.49 | $645.65 | $1,174.90 |
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 $158.49 Median $281.84 Typical High $588.84 | Professional | None | $158.49 | $281.84 | $588.84 |
Well Sense Setting Facility Modifier None Typical Low $100.00 Median $144.54 Typical High $234.42 | Facility | None | $100.00 | $144.54 | $234.42 |
Well Sense Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $190.55 | Professional | None | $104.71 | $125.89 | $190.55 |
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 $54.95 Median $83.18 Typical High $204.17 | Professional | 52 · Reduced service | $54.95 | $83.18 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $33.11 Typical High $81.28 | Professional | 53 · Discontinued | $21.88 | $33.11 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $125.89 Typical High $302.00 | Professional | 54 · Surgery only | $81.28 | $125.89 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $25.12 Typical High $60.26 | Professional | 55 · Aftercare only | $16.22 | $25.12 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.60 Typical High $40.74 | Professional | 56 · Pre-op care only | $10.96 | $16.60 | $40.74 |
Where Massachusetts sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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
$275
WI $537MD $182
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.