How much rates vary
Facilitymedian $708 · 10th to 90th $145 to $3,631Professionalmedian $1,549 · 10th to 90th $162 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 $107.15 Median $1,258.93 Typical High $1,862.09 | Professional | None | $107.15 | $1,258.93 | $1,862.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $1,288.25 Typical High $3,630.78 | Facility | None | $457.09 | $1,288.25 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $169.82 Median $1,698.24 Typical High $10,000.00 | Professional | None | $169.82 | $1,698.24 | $10,000.00 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $338.84 | Facility | None | $144.54 | $144.54 | $338.84 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $144.54 Median $851.14 Typical High $2,884.03 | Professional | None | $144.54 | $851.14 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $2,238.72 | Facility | None | $676.08 | $1,737.80 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $645.65 Typical High $3,630.78 | Professional | None | $229.09 | $645.65 | $3,630.78 |
Fallon Health Setting Facility Modifier None Typical Low $134.90 Median $177.83 Typical High $3,311.31 | Facility | None | $134.90 | $177.83 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,995.26 | $2,454.71 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $165.96 Median $1,380.38 Typical High $3,981.07 | Professional | None | $165.96 | $1,380.38 | $3,981.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $1,288.25 Typical High $3,630.78 | Facility | None | $457.09 | $1,288.25 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $169.82 Median $1,698.24 Typical High $10,000.00 | Professional | None | $169.82 | $1,698.24 | $10,000.00 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,918.31 | Facility | None | $575.44 | $1,380.38 | $6,918.31 |
United Setting Professional Modifier None Typical Low $199.53 Median $1,548.82 Typical High $4,897.79 | Professional | None | $199.53 | $1,548.82 | $4,897.79 |
Well Sense Setting Facility Modifier None Typical Low $131.83 Median $691.83 Typical High $1,698.24 | Facility | None | $131.83 | $691.83 | $1,698.24 |
Well Sense Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $1,348.96 | Professional | None | $117.49 | $141.25 | $1,348.96 |
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 $52.48 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $52.48 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $21.38 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $79.43 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $15.85 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $10.72 | $125.89 | $125.89 |
Where Massachusetts sits
The same service costs 8.5 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· 36th of 51
$1,259
WI $2,291NE $269
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.