How much rates vary
Facilitymedian $126 · 10th to 90th $66 to $2,692Professionalmedian $158 · 10th to 90th $71 to $389
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $114.82 Typical High $158.49 | Professional | None | $51.29 | $114.82 | $158.49 |
AllWays Health Partners Setting Facility Modifier None Typical Low $48.98 Median $501.19 Typical High $2,818.38 | Facility | None | $48.98 | $501.19 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $74.13 Median $173.78 Typical High $977.24 | Professional | None | $74.13 | $173.78 | $977.24 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $154.88 | Facility | None | $66.07 | $66.07 | $154.88 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $269.15 | Professional | None | $66.07 | $154.88 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $758.58 Typical High $1,000.00 | Facility | None | $676.08 | $758.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $302.00 | Professional | None | $81.28 | $154.88 | $302.00 |
Fallon Health Setting Facility Modifier None Typical Low $66.07 Median $85.11 Typical High $3,311.31 | Facility | None | $66.07 | $85.11 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $239.88 | Professional | None | $162.18 | $194.98 | $239.88 |
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 $74.13 Median $165.96 Typical High $363.08 | Professional | None | $74.13 | $165.96 | $363.08 |
Health New England Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $4,365.16 | Facility | None | $363.08 | $588.84 | $4,365.16 |
Health New England Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $208.93 | Professional | None | $138.04 | $162.18 | $208.93 |
Mass General Brigham Setting Facility Modifier None Typical Low $48.98 Median $501.19 Typical High $2,818.38 | Facility | None | $48.98 | $501.19 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $74.13 Median $173.78 Typical High $977.24 | Professional | None | $74.13 | $173.78 | $977.24 |
United Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $2,818.38 | Facility | None | $117.49 | $537.03 | $2,818.38 |
United Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $354.81 | Professional | None | $85.11 | $169.82 | $354.81 |
Well Sense Setting Facility Modifier None Typical Low $56.23 Median $95.50 Typical High $154.88 | Facility | None | $56.23 | $95.50 | $154.88 |
Well Sense Setting Professional Modifier None Typical Low $47.86 Median $57.54 Typical High $263.03 | Professional | None | $47.86 | $57.54 | $263.03 |
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 $25.70 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $25.70 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $10.23 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $87.10 Typical High $87.10 | Professional | 54 · Surgery only | $38.90 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $7.76 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $5.13 | $11.48 | $11.48 |
Where Massachusetts sits
The same service costs 22.5 times more in Alabama 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.
Physician feeFacility fee
AL $5,010KY $223
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.