How much rates vary
Facilitymedian $148 · 10th to 90th $34 to $2,239Professionalmedian $120 · 10th to 90th $35 to $851
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 $323.59 Median $2,187.76 Typical High $3,630.78 | Facility | None | $323.59 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $100.00 Typical High $147.91 | Professional | None | $34.67 | $100.00 | $147.91 |
AllWays Health Partners Setting Facility Modifier None Typical Low $75.86 Median $489.78 Typical High $1,862.09 | Facility | None | $75.86 | $489.78 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $40.74 Median $144.54 Typical High $851.14 | Professional | None | $40.74 | $144.54 | $851.14 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $33.11 Median $40.74 Typical High $75.86 | Facility | None | $33.11 | $40.74 | $75.86 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $208.93 | Professional | None | $57.54 | $57.54 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $165.96 Typical High $199.53 | Facility | None | $53.70 | $165.96 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $134.90 Typical High $263.03 | Professional | None | $39.81 | $134.90 | $263.03 |
Fallon Health Setting Facility Modifier None Typical Low $35.48 Median $44.67 Typical High $3,311.31 | Facility | None | $35.48 | $44.67 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $190.55 | Professional | None | $125.89 | $151.36 | $190.55 |
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 $35.48 Median $120.23 Typical High $302.00 | Professional | None | $35.48 | $120.23 | $302.00 |
Mass General Brigham Setting Facility Modifier None Typical Low $75.86 Median $489.78 Typical High $1,862.09 | Facility | None | $75.86 | $489.78 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $40.74 Median $144.54 Typical High $851.14 | Professional | None | $40.74 | $144.54 | $851.14 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $42.66 Median $120.23 Typical High $371.54 | Professional | None | $42.66 | $120.23 | $371.54 |
Well Sense Setting Facility Modifier None Typical Low $26.30 Median $75.86 Typical High $128.82 | Facility | None | $26.30 | $75.86 | $128.82 |
Well Sense Setting Professional Modifier None Typical Low $24.55 Median $29.51 Typical High $93.33 | Professional | None | $24.55 | $29.51 | $93.33 |
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 $17.38 Median $50.12 Typical High $58.88 | Professional | 52 · Reduced service | $17.38 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $19.95 Typical High $23.44 | Professional | 53 · Discontinued | $6.92 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $74.13 Typical High $87.10 | Professional | 54 · Surgery only | $26.30 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $5.25 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $10.00 Typical High $11.75 | Professional | 56 · Pre-op care only | $3.47 | $10.00 | $11.75 |
Where Massachusetts sits
The same service costs 5.4 times more in Wisconsin than in Hawaii. 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· 14th of 51
$123
WI $209HI $38.90
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.