How much rates vary
Facilitymedian $324 · 10th to 90th $91 to $2,512Professionalmedian $200 · 10th to 90th $100 to $1,023
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 $100.00 Median $2,691.53 Typical High $5,128.61 | Facility | None | $100.00 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $288.40 | Professional | None | $70.79 | $100.00 | $288.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $269.15 Median $562.34 Typical High $2,089.30 | Facility | None | $269.15 | $562.34 | $2,089.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $100.00 Median $223.87 Typical High $1,023.29 | Professional | None | $100.00 | $223.87 | $1,023.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $208.93 | Facility | None | $91.20 | $91.20 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $524.81 Typical High $660.69 | Facility | None | $100.00 | $524.81 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $354.81 | Professional | None | $138.04 | $204.17 | $354.81 |
Fallon Health Setting Facility Modifier None Typical Low $91.20 Median $117.49 Typical High $3,311.31 | Facility | None | $91.20 | $117.49 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $239.88 | Professional | None | $165.96 | $194.98 | $239.88 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $102.33 Median $208.93 Typical High $407.38 | Professional | None | $102.33 | $208.93 | $407.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $269.15 Median $562.34 Typical High $2,089.30 | Facility | None | $269.15 | $562.34 | $2,089.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $100.00 Median $223.87 Typical High $1,023.29 | Professional | None | $100.00 | $223.87 | $1,023.29 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $416.87 | Professional | None | $114.82 | $181.97 | $416.87 |
Well Sense Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $269.15 | Facility | None | $79.43 | $131.83 | $269.15 |
Well Sense Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $128.82 | Professional | None | $75.86 | $91.20 | $128.82 |
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 $35.48 Median $50.12 Typical High $144.54 | Professional | 52 · Reduced service | $35.48 | $50.12 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $19.95 Typical High $58.88 | Professional | 53 · Discontinued | $14.13 | $19.95 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $74.13 Typical High $218.78 | Professional | 54 · Surgery only | $52.48 | $74.13 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $14.79 Typical High $43.65 | Professional | 55 · Aftercare only | $10.47 | $14.79 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.00 Typical High $28.84 | Professional | 56 · Pre-op care only | $7.08 | $10.00 | $28.84 |
Where Massachusetts sits
The same service costs 3.5 times more in Alaska than in Indiana. 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· 13th of 51
$204
AK $447IN $126
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.