How much rates vary
Facilitymedian $178 · 10th to 90th $115 to $2,818Professionalmedian $617 · 10th to 90th $132 to $4,074
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 $83.18 Median $354.81 Typical High $602.56 | Professional | None | $83.18 | $354.81 | $602.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $269.15 Median $1,023.29 Typical High $3,548.13 | Facility | None | $269.15 | $1,023.29 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $151.36 Median $812.83 Typical High $4,073.80 | Professional | None | $151.36 | $812.83 | $4,073.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $269.15 | Facility | None | $114.82 | $114.82 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $549.54 Typical High $1,318.26 | Professional | None | $181.97 | $549.54 | $1,318.26 |
Fallon Health Setting Facility Modifier None Typical Low $117.49 Median $144.54 Typical High $3,311.31 | Facility | None | $117.49 | $144.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,148.15 | Professional | None | $676.08 | $831.76 | $1,148.15 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $128.82 Median $537.03 Typical High $1,548.82 | Professional | None | $128.82 | $537.03 | $1,548.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $269.15 Median $1,023.29 Typical High $3,548.13 | Facility | None | $269.15 | $1,023.29 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $151.36 Median $812.83 Typical High $4,073.80 | Professional | None | $151.36 | $812.83 | $4,073.80 |
United Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $147.91 Median $537.03 Typical High $1,698.24 | Professional | None | $147.91 | $537.03 | $1,698.24 |
Well Sense Setting Facility Modifier None Typical Low $104.71 Median $204.17 Typical High $724.44 | Facility | None | $104.71 | $204.17 | $724.44 |
Well Sense Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $501.19 | Professional | None | $100.00 | $120.23 | $501.19 |
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 $41.69 Median $177.83 Typical High $295.12 | Professional | 52 · Reduced service | $41.69 | $177.83 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $70.79 Typical High $120.23 | Professional | 53 · Discontinued | $16.60 | $70.79 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $269.15 Typical High $446.68 | Professional | 54 · Surgery only | $61.66 | $269.15 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $53.70 Typical High $89.13 | Professional | 55 · Aftercare only | $12.30 | $53.70 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $35.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $8.32 | $35.48 | $60.26 |
Where Massachusetts sits
The same service costs 4.0 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
$575
WI $851MD $214
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.