How much rates vary
Facilitymedian $102 · 10th to 90th $68 to $2,818Professionalmedian $200 · 10th to 90th $68 to $661
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 $47.86 Median $154.88 Typical High $251.19 | Professional | None | $47.86 | $154.88 | $251.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $190.55 Median $1,819.70 Typical High $3,548.13 | Facility | None | $190.55 | $1,819.70 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $79.43 Median $263.03 Typical High $1,258.93 | Professional | None | $79.43 | $263.03 | $1,258.93 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $158.49 | Facility | None | $67.61 | $67.61 | $158.49 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $67.61 Median $199.53 Typical High $199.53 | Professional | None | $67.61 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $398.11 | Professional | None | $107.15 | $213.80 | $398.11 |
Fallon Health Setting Facility Modifier None Typical Low $67.61 Median $83.18 Typical High $3,311.31 | Facility | None | $67.61 | $83.18 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $346.74 | Professional | None | $213.80 | $257.04 | $346.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $79.43 Median $204.17 Typical High $478.63 | Professional | None | $79.43 | $204.17 | $478.63 |
Health New England Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Health New England Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $912.01 | Professional | None | $275.42 | $281.84 | $912.01 |
Mass General Brigham Setting Facility Modifier None Typical Low $190.55 Median $1,819.70 Typical High $3,548.13 | Facility | None | $190.55 | $1,819.70 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $79.43 Median $263.03 Typical High $1,258.93 | Professional | None | $79.43 | $263.03 | $1,258.93 |
United Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $512.86 | Professional | None | $79.43 | $218.78 | $512.86 |
Well Sense Setting Facility Modifier None Typical Low $58.88 Median $117.49 Typical High $223.87 | Facility | None | $58.88 | $117.49 | $223.87 |
Well Sense Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $177.83 | Professional | None | $66.07 | $79.43 | $177.83 |
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 $23.99 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $23.99 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $9.55 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $114.82 Typical High $114.82 | Professional | 54 · Surgery only | $36.31 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $7.24 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $4.79 | $15.49 | $15.49 |
Where Massachusetts sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 13th of 51
$200
WI $316UT $117
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.