How much rates vary
Facilitymedian $178 · 10th to 90th $78 to $2,692Professionalmedian $295 · 10th to 90th $95 to $912
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $199.53 Typical High $199.53 | Professional | None | $58.88 | $199.53 | $199.53 |
AllWays Health Partners Setting Facility Modifier None Typical Low $61.66 Median $501.19 Typical High $2,818.38 | Facility | None | $61.66 | $501.19 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $95.50 Median $331.13 Typical High $1,778.28 | Professional | None | $95.50 | $331.13 | $1,778.28 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $194.98 | Facility | None | $83.18 | $83.18 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $758.58 Typical High $1,000.00 | Facility | None | $676.08 | $758.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $380.19 Typical High $660.69 | Professional | None | $134.90 | $380.19 | $660.69 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $107.15 Typical High $3,311.31 | Facility | None | $83.18 | $107.15 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $426.58 | Professional | None | $295.12 | $346.74 | $426.58 |
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 $95.50 Median $288.40 Typical High $676.08 | Professional | None | $95.50 | $288.40 | $676.08 |
Mass General Brigham Setting Facility Modifier None Typical Low $61.66 Median $501.19 Typical High $2,818.38 | Facility | None | $61.66 | $501.19 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $95.50 Median $331.13 Typical High $1,778.28 | Professional | None | $95.50 | $331.13 | $1,778.28 |
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 $117.49 Median $371.54 Typical High $891.25 | Professional | None | $117.49 | $371.54 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $75.86 Median $147.91 Typical High $323.59 | Facility | None | $75.86 | $147.91 | $323.59 |
Well Sense Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $186.21 | Professional | None | $60.26 | $72.44 | $186.21 |
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 $29.51 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $29.51 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $11.75 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $147.91 Typical High $147.91 | Professional | 54 · Surgery only | $43.65 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $8.71 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $5.89 | $19.95 | $19.95 |
Where Massachusetts sits
The same service costs 3.6 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· 24th of 51
$288
WI $537NE $148
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.