How much rates vary
Facilitymedian $95 · 10th to 90th $50 to $2,399Professionalmedian $126 · 10th to 90th $58 to $372
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 $63.10 Median $2,691.53 Typical High $5,128.61 | Facility | None | $63.10 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $63.10 Typical High $141.25 | Professional | None | $38.02 | $63.10 | $141.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $37.15 Median $501.19 Typical High $2,344.23 | Facility | None | $37.15 | $501.19 | $2,344.23 |
AllWays Health Partners Setting Professional Modifier None Typical Low $64.57 Median $138.04 Typical High $1,071.52 | Professional | None | $64.57 | $138.04 | $1,071.52 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $114.82 | Facility | None | $50.12 | $50.12 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,380.38 Typical High $1,380.38 | Facility | None | $831.76 | $1,380.38 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $141.25 Typical High $229.09 | Professional | None | $81.28 | $141.25 | $229.09 |
Fallon Health Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $3,311.31 | Facility | None | $50.12 | $66.07 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $151.36 | Professional | None | $104.71 | $123.03 | $151.36 |
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 $57.54 Median $125.89 Typical High $245.47 | Professional | None | $57.54 | $125.89 | $245.47 |
Mass General Brigham Setting Facility Modifier None Typical Low $37.15 Median $501.19 Typical High $2,344.23 | Facility | None | $37.15 | $501.19 | $2,344.23 |
Mass General Brigham Setting Professional Modifier None Typical Low $64.57 Median $138.04 Typical High $1,071.52 | Professional | None | $64.57 | $138.04 | $1,071.52 |
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 $72.44 Median $138.04 Typical High $316.23 | Professional | None | $72.44 | $138.04 | $316.23 |
Well Sense Setting Facility Modifier None Typical Low $45.71 Median $72.44 Typical High $104.71 | Facility | None | $45.71 | $72.44 | $104.71 |
Well Sense Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $81.28 | Professional | None | $43.65 | $52.48 | $81.28 |
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 $19.05 Median $31.62 Typical High $83.18 | Professional | 52 · Reduced service | $19.05 | $31.62 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $12.88 Typical High $33.11 | Professional | 53 · Discontinued | $7.59 | $12.88 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $47.86 Typical High $125.89 | Professional | 54 · Surgery only | $28.84 | $47.86 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $9.55 Typical High $25.12 | Professional | 55 · Aftercare only | $5.75 | $9.55 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.31 Typical High $16.60 | Professional | 56 · Pre-op care only | $3.80 | $6.31 | $16.60 |
Where Massachusetts sits
The same service costs 3.7 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· 16th of 51
$120
WI $282FL $75.86
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.