How much rates vary
Facilitymedian $87 · 10th to 90th $9 to $2,042Professionalmedian $33 · 10th to 90th $10 to $155
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 $6.17 Median $18.20 Typical High $79.43 | Facility | None | $6.17 | $18.20 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $18.20 Typical High $35.48 | Professional | None | $6.17 | $18.20 | $35.48 |
AllWays Health Partners 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 |
AllWays Health Partners Setting Professional Modifier None Typical Low $12.59 Median $47.86 Typical High $338.84 | Professional | None | $12.59 | $47.86 | $338.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $20.42 | Facility | None | $8.71 | $8.71 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $2,691.53 | Facility | None | $831.76 | $831.76 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $42.66 Typical High $77.62 | Professional | None | $14.13 | $42.66 | $77.62 |
Fallon Health Setting Facility Modifier None Typical Low $8.13 Median $36.31 Typical High $36.31 | Facility | None | $8.13 | $36.31 | $36.31 |
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 $9.77 Median $33.11 Typical High $89.13 | Professional | None | $9.77 | $33.11 | $89.13 |
Health New England Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Mass General Brigham 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 |
Mass General Brigham Setting Professional Modifier None Typical Low $12.59 Median $47.86 Typical High $338.84 | Professional | None | $12.59 | $47.86 | $338.84 |
Tufts Setting Facility Modifier None Typical Low $6.61 Median $7.76 Typical High $524.81 | Facility | None | $6.61 | $7.76 | $524.81 |
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 $12.02 Median $38.90 Typical High $97.72 | Professional | None | $12.02 | $38.90 | $97.72 |
Well Sense Setting Facility Modifier None Typical Low $7.94 Median $15.49 Typical High $40.74 | Facility | None | $7.94 | $15.49 | $40.74 |
Well Sense Setting Professional Modifier None Typical Low $7.24 Median $8.71 Typical High $19.50 | Professional | None | $7.24 | $8.71 | $19.50 |
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 $3.02 Median $9.12 Typical High $14.13 | Professional | 52 · Reduced service | $3.02 | $9.12 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $3.63 Typical High $5.62 | Professional | 53 · Discontinued | $1.23 | $3.63 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.57 Median $13.49 Typical High $20.89 | Professional | 54 · Surgery only | $4.57 | $13.49 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $2.69 Typical High $4.17 | Professional | 55 · Aftercare only | $0.91 | $2.69 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $1.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $0.62 | $1.82 | $2.82 |
Where Massachusetts sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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
$38.02
WI $67.61NE $16.22
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.