How much rates vary
Facilitymedian $437 · 10th to 90th $107 to $2,951Professionalmedian $295 · 10th to 90th $117 to $1,122
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 $588.84 Median $2,691.53 Typical High $3,715.35 | Facility | None | $588.84 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $147.91 Typical High $302.00 | Professional | None | $74.13 | $147.91 | $302.00 |
AllWays Health Partners Setting Facility Modifier None Typical Low $269.15 Median $660.69 Typical High $2,511.89 | Facility | None | $269.15 | $660.69 | $2,511.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $123.03 Median $295.12 Typical High $1,905.46 | Professional | None | $123.03 | $295.12 | $1,905.46 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $107.15 Median $128.82 Typical High $239.88 | Facility | None | $107.15 | $128.82 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $870.96 Typical High $1,258.93 | Facility | None | $588.84 | $870.96 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $389.05 Typical High $562.34 | Professional | None | $169.82 | $389.05 | $562.34 |
Fallon Health Setting Facility Modifier None Typical Low $107.15 Median $141.25 Typical High $3,311.31 | Facility | None | $107.15 | $141.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $457.09 | Professional | None | $316.23 | $371.54 | $457.09 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $117.49 Median $309.03 Typical High $741.31 | Professional | None | $117.49 | $309.03 | $741.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $269.15 Median $660.69 Typical High $2,511.89 | Facility | None | $269.15 | $660.69 | $2,511.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $123.03 Median $295.12 Typical High $1,905.46 | Professional | None | $123.03 | $295.12 | $1,905.46 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $5,128.61 | Facility | None | $407.38 | $870.96 | $5,128.61 |
United Setting Professional Modifier None Typical Low $147.91 Median $295.12 Typical High $812.83 | Professional | None | $147.91 | $295.12 | $812.83 |
Well Sense Setting Facility Modifier None Typical Low $95.50 Median $186.21 Typical High $338.84 | Facility | None | $95.50 | $186.21 | $338.84 |
Well Sense Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $151.36 | Professional | None | $77.62 | $93.33 | $151.36 |
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 $37.15 Median $72.44 Typical High $151.36 | Professional | 52 · Reduced service | $37.15 | $72.44 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $29.51 Typical High $60.26 | Professional | 53 · Discontinued | $15.14 | $29.51 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $109.65 Typical High $223.87 | Professional | 54 · Surgery only | $56.23 | $109.65 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $21.88 Typical High $44.67 | Professional | 55 · Aftercare only | $11.22 | $21.88 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $14.79 Typical High $30.20 | Professional | 56 · Pre-op care only | $7.59 | $14.79 | $30.20 |
Where Massachusetts sits
The same service costs 4.3 times more in Alaska 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· 20th of 51
$309
AK $776KY $182
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.