How much rates vary
Facilitymedian $468 · 10th to 90th $269 to $6,166Professionalmedian $1,288 · 10th to 90th $269 to $4,467
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $912.01 Typical High $1,548.82 | Professional | None | $194.98 | $912.01 | $1,548.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $630.96 Median $5,248.07 Typical High $8,709.64 | Facility | None | $630.96 | $5,248.07 | $8,709.64 |
AllWays Health Partners Setting Professional Modifier None Typical Low $302.00 Median $1,548.82 Typical High $9,332.54 | Professional | None | $302.00 | $1,548.82 | $9,332.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $630.96 | Facility | None | $269.15 | $269.15 | $630.96 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $269.15 Median $588.84 Typical High $1,513.56 | Professional | None | $269.15 | $588.84 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $1,096.48 Typical High $2,754.23 | Professional | None | $407.38 | $1,096.48 | $2,754.23 |
Fallon Health Setting Facility Modifier None Typical Low $251.19 Median $338.84 Typical High $3,311.31 | Facility | None | $251.19 | $338.84 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,548.82 | $1,905.46 | $2,630.27 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,398.83 Median $5,248.07 Typical High $11,481.54 | Facility | None | $2,398.83 | $5,248.07 | $11,481.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,801.89 | Professional | None | $309.03 | $1,380.38 | $3,801.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $630.96 Median $5,248.07 Typical High $8,709.64 | Facility | None | $630.96 | $5,248.07 | $8,709.64 |
Mass General Brigham Setting Professional Modifier None Typical Low $302.00 Median $1,548.82 Typical High $9,332.54 | Professional | None | $302.00 | $1,548.82 | $9,332.54 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $6,309.57 Typical High $11,481.54 | Facility | None | $2,398.83 | $6,309.57 | $11,481.54 |
United Setting Professional Modifier None Typical Low $354.81 Median $1,258.93 Typical High $3,801.89 | Professional | None | $354.81 | $1,258.93 | $3,801.89 |
Well Sense Setting Facility Modifier None Typical Low $239.88 Median $467.74 Typical High $1,621.81 | Facility | None | $239.88 | $467.74 | $1,621.81 |
Well Sense Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $1,412.54 | Professional | None | $204.17 | $245.47 | $1,412.54 |
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 $95.50 Median $457.09 Typical High $645.65 | Professional | 52 · Reduced service | $95.50 | $457.09 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $181.97 Typical High $257.04 | Professional | 53 · Discontinued | $38.90 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $676.08 Typical High $977.24 | Professional | 54 · Surgery only | $144.54 | $676.08 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $138.04 Typical High $194.98 | Professional | 55 · Aftercare only | $28.84 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $91.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $19.50 | $91.20 | $128.82 |
Where Massachusetts sits
The same service costs 5.1 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· 19th of 51
$1,288
WI $2,042MD $398
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.