How much rates vary
Facilitymedian $72 · 10th to 90th $45 to $2,818Professionalmedian $132 · 10th to 90th $45 to $759
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 $537.03 Median $2,691.53 Typical High $3,715.35 | Facility | None | $537.03 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $109.65 Typical High $186.21 | Professional | None | $33.11 | $109.65 | $186.21 |
AllWays Health Partners Setting Facility Modifier None Typical Low $104.71 Median $1,023.29 Typical High $3,548.13 | Facility | None | $104.71 | $1,023.29 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $60.26 Median $204.17 Typical High $1,071.52 | Professional | None | $60.26 | $204.17 | $1,071.52 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $104.71 | Facility | None | $44.67 | $44.67 | $104.71 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $44.67 Median $131.83 Typical High $131.83 | Professional | None | $44.67 | $131.83 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $128.82 Typical High $281.84 | Professional | None | $70.79 | $128.82 | $281.84 |
Fallon Health Setting Facility Modifier None Typical Low $45.71 Median $56.23 Typical High $3,311.31 | Facility | None | $45.71 | $56.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $229.09 | Professional | None | $138.04 | $169.82 | $229.09 |
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 $51.29 Median $134.90 Typical High $338.84 | Professional | None | $51.29 | $134.90 | $338.84 |
Health New England Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Health New England Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $269.15 | Professional | None | $162.18 | $165.96 | $269.15 |
Mass General Brigham Setting Facility Modifier None Typical Low $104.71 Median $1,023.29 Typical High $3,548.13 | Facility | None | $104.71 | $1,023.29 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $60.26 Median $204.17 Typical High $1,071.52 | Professional | None | $60.26 | $204.17 | $1,071.52 |
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 $57.54 Median $162.18 Typical High $398.11 | Professional | None | $57.54 | $162.18 | $398.11 |
Well Sense Setting Facility Modifier None Typical Low $40.74 Median $81.28 Typical High $147.91 | Facility | None | $40.74 | $81.28 | $147.91 |
Well Sense Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $154.88 | Professional | None | $39.81 | $47.86 | $154.88 |
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 $16.60 Median $54.95 Typical High $79.43 | Professional | 52 · Reduced service | $16.60 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $21.88 Typical High $31.62 | Professional | 53 · Discontinued | $6.61 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $81.28 Typical High $117.49 | Professional | 54 · Surgery only | $24.55 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $16.22 Typical High $23.44 | Professional | 55 · Aftercare only | $4.90 | $16.22 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $10.96 Typical High $15.85 | Professional | 56 · Pre-op care only | $3.31 | $10.96 | $15.85 |
Where Massachusetts sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 24th of 51
$132
WI $234FL $85.11
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.