How much rates vary
Facilitymedian $35 · 10th to 90th $13 to $1,122Professionalmedian $36 · 10th to 90th $16 to $129
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 $10.23 Median $22.91 Typical High $74.13 | Facility | None | $10.23 | $22.91 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $22.39 Typical High $44.67 | Professional | None | $10.23 | $22.39 | $44.67 |
AllWays Health Partners Setting Facility Modifier None Typical Low $10.72 Median $72.44 Typical High $1,023.29 | Facility | None | $10.72 | $72.44 | $1,023.29 |
AllWays Health Partners Setting Professional Modifier None Typical Low $14.45 Median $37.15 Typical High $208.93 | Professional | None | $14.45 | $37.15 | $208.93 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $14.45 Median $17.38 Typical High $32.36 | Facility | None | $14.45 | $17.38 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $53.70 Typical High $831.76 | Facility | None | $50.12 | $53.70 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $45.71 Typical High $66.07 | Professional | None | $22.91 | $45.71 | $66.07 |
Fallon Health Setting Facility Modifier None Typical Low $14.45 Median $18.62 Typical High $3,311.31 | Facility | None | $14.45 | $18.62 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $32.36 Median $39.81 Typical High $47.86 | Professional | None | $32.36 | $39.81 | $47.86 |
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 $16.22 Median $36.31 Typical High $79.43 | Professional | None | $16.22 | $36.31 | $79.43 |
Health New England Setting Facility Modifier None Typical Low $23.99 Median $35.48 Typical High $151.36 | Facility | None | $23.99 | $35.48 | $151.36 |
Mass General Brigham Setting Facility Modifier None Typical Low $10.72 Median $72.44 Typical High $1,023.29 | Facility | None | $10.72 | $72.44 | $1,023.29 |
Mass General Brigham Setting Professional Modifier None Typical Low $14.45 Median $37.15 Typical High $208.93 | Professional | None | $14.45 | $37.15 | $208.93 |
United Setting Facility Modifier None Typical Low $123.03 Median $524.81 Typical High $2,754.23 | Facility | None | $123.03 | $524.81 | $2,754.23 |
United Setting Professional Modifier None Typical Low $18.62 Median $39.81 Typical High $91.20 | Professional | None | $18.62 | $39.81 | $91.20 |
Well Sense Setting Facility Modifier None Typical Low $13.18 Median $23.44 Typical High $35.48 | Facility | None | $13.18 | $23.44 | $35.48 |
Well Sense Setting Professional Modifier None Typical Low $11.22 Median $13.49 Typical High $23.44 | Professional | None | $11.22 | $13.49 | $23.44 |
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 $5.13 Median $11.22 Typical High $21.88 | Professional | 52 · Reduced service | $5.13 | $11.22 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $4.47 Typical High $8.91 | Professional | 53 · Discontinued | $2.04 | $4.47 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.59 Median $16.60 Typical High $33.11 | Professional | 54 · Surgery only | $7.59 | $16.60 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $3.31 Typical High $6.61 | Professional | 55 · Aftercare only | $1.51 | $3.31 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $2.24 Typical High $4.47 | Professional | 56 · Pre-op care only | $1.02 | $2.24 | $4.47 |
Where Massachusetts sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 17th of 51
$36.31
WI $87.10KY $25.12
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.