How much rates vary
Facilitymedian $1,862 · 10th to 90th $195 to $6,310Professionalmedian $295 · 10th to 90th $162 to $47,863
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 $2,089.30 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,089.30 | $3,019.95 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | None | $162.18 | $162.18 | $199.53 |
AllWays Health Partners Setting Facility Modifier None Typical Low $758.58 Median $2,630.27 Typical High $7,413.10 | Facility | None | $758.58 | $2,630.27 | $7,413.10 |
AllWays Health Partners Setting Professional Modifier None Typical Low $173.78 Median $416.87 Typical High $47,863.01 | Professional | None | $173.78 | $416.87 | $47,863.01 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $398.11 | Professional | None | $173.78 | $295.12 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,715.35 Typical High $4,786.30 | Facility | None | $741.31 | $3,715.35 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $630.96 | Professional | None | $295.12 | $295.12 | $630.96 |
Fallon Health Setting Facility Modifier None Typical Low $173.78 Median $229.09 Typical High $3,311.31 | Facility | None | $173.78 | $229.09 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $269.15 | Professional | None | $186.21 | $218.78 | $269.15 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $190.55 Median $354.81 Typical High $630.96 | Professional | None | $190.55 | $354.81 | $630.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $758.58 Median $2,630.27 Typical High $7,413.10 | Facility | None | $758.58 | $2,630.27 | $7,413.10 |
Mass General Brigham Setting Professional Modifier None Typical Low $173.78 Median $416.87 Typical High $47,863.01 | Professional | None | $173.78 | $416.87 | $47,863.01 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $12,882.50 | Facility | None | $1,071.52 | $3,467.37 | $12,882.50 |
United Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $707.95 | Professional | None | $223.87 | $302.00 | $707.95 |
Well Sense Setting Facility Modifier None Typical Low $154.88 Median $245.47 Typical High $1,621.81 | Facility | None | $154.88 | $245.47 | $1,621.81 |
Well Sense Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | None | $141.25 | $141.25 | $169.82 |
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 $81.28 Median $81.28 Typical High $93.33 | Professional | 52 · Reduced service | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | 53 · Discontinued | $32.36 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 54 · Surgery only | $123.03 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $28.18 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $18.62 |
Where Massachusetts sits
The same service costs 10.2 times more in Oklahoma 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· 21st of 51
$339
OK $1,950KY $191
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.