How much rates vary
Facilitymedian $347 · 10th to 90th $200 to $6,607Professionalmedian $933 · 10th to 90th $224 to $4,898
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $676.08 Typical High $912.01 | Professional | None | $213.80 | $676.08 | $912.01 |
AllWays Health Partners Setting Facility Modifier None Typical Low $588.84 Median $6,165.95 Typical High $9,549.93 | Facility | None | $588.84 | $6,165.95 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $234.42 Median $1,096.48 Typical High $6,025.60 | Professional | None | $234.42 | $1,096.48 | $6,025.60 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $467.74 | Facility | None | $199.53 | $199.53 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $758.58 Typical High $1,995.26 | Professional | None | $323.59 | $758.58 | $1,995.26 |
Fallon Health Setting Facility Modifier None Typical Low $204.17 Median $251.19 Typical High $3,311.31 | Facility | None | $204.17 | $251.19 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,230.27 | $1,698.24 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,398.83 Median $5,248.07 Typical High $11,481.54 | Facility | None | $2,398.83 | $5,248.07 | $11,481.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $223.87 Median $891.25 Typical High $2,454.71 | Professional | None | $223.87 | $891.25 | $2,454.71 |
Mass General Brigham Setting Facility Modifier None Typical Low $588.84 Median $6,165.95 Typical High $9,549.93 | Facility | None | $588.84 | $6,165.95 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $234.42 Median $1,096.48 Typical High $6,025.60 | Professional | None | $234.42 | $1,096.48 | $6,025.60 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $6,309.57 Typical High $12,302.69 | Facility | None | $2,398.83 | $6,309.57 | $12,302.69 |
United Setting Professional Modifier None Typical Low $269.15 Median $870.96 Typical High $2,818.38 | Professional | None | $269.15 | $870.96 | $2,818.38 |
Well Sense Setting Facility Modifier None Typical Low $177.83 Median $354.81 Typical High $1,122.02 | Facility | None | $177.83 | $354.81 | $1,122.02 |
Well Sense Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $660.69 | Professional | None | $281.84 | $338.84 | $660.69 |
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 $107.15 Median $338.84 Typical High $436.52 | Professional | 52 · Reduced service | $107.15 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $134.90 Typical High $173.78 | Professional | 53 · Discontinued | $42.66 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $501.19 Typical High $645.65 | Professional | 54 · Surgery only | $158.49 | $501.19 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $100.00 Typical High $128.82 | Professional | 55 · Aftercare only | $31.62 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $67.61 Typical High $87.10 | Professional | 56 · Pre-op care only | $21.38 | $67.61 | $87.10 |
Where Massachusetts sits
The same service costs 5.4 times more in Wisconsin than in Maryland. 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· 11th of 51
$912
WI $1,514MD $282
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.