How much rates vary
Facilitymedian $93 · 10th to 90th $43 to $2,818Professionalmedian $138 · 10th to 90th $69 to $759
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 $74.13 Median $104.71 Typical High $144.54 | Professional | None | $74.13 | $104.71 | $144.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $162.18 Median $1,122.02 Typical High $3,162.28 | Facility | None | $162.18 | $1,122.02 | $3,162.28 |
AllWays Health Partners Setting Professional Modifier None Typical Low $72.44 Median $190.55 Typical High $3,715.35 | Professional | None | $72.44 | $190.55 | $3,715.35 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $69.18 Median $85.11 Typical High $158.49 | Facility | None | $69.18 | $85.11 | $158.49 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $69.18 Median $138.04 Typical High $138.04 | Professional | None | $69.18 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $295.12 | Professional | None | $95.50 | $162.18 | $295.12 |
Fallon Health Setting Facility Modifier None Typical Low $39.81 Median $79.43 Typical High $380.19 | Facility | None | $39.81 | $79.43 | $380.19 |
Fallon Health Setting Professional Modifier None Typical Low $77.62 Median $131.83 Typical High $199.53 | Professional | None | $77.62 | $131.83 | $199.53 |
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 $75.86 Median $162.18 Typical High $346.74 | Professional | None | $75.86 | $162.18 | $346.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $162.18 Median $1,122.02 Typical High $3,162.28 | Facility | None | $162.18 | $1,122.02 | $3,162.28 |
Mass General Brigham Setting Professional Modifier None Typical Low $72.44 Median $190.55 Typical High $3,715.35 | Professional | None | $72.44 | $190.55 | $3,715.35 |
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 $75.86 Median $147.91 Typical High $416.87 | Professional | None | $75.86 | $147.91 | $416.87 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $102.33 Typical High $147.91 | Facility | None | $60.26 | $102.33 | $147.91 |
Well Sense Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $93.33 | Professional | None | $54.95 | $66.07 | $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 $37.15 Median $52.48 Typical High $67.61 | Professional | 52 · Reduced service | $37.15 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.89 Typical High $26.92 | Professional | 53 · Discontinued | $14.79 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $79.43 Typical High $102.33 | Professional | 54 · Surgery only | $56.23 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.85 Typical High $20.42 | Professional | 55 · Aftercare only | $11.22 | $15.85 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.47 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.41 | $10.47 | $13.49 |
Where Massachusetts sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 16th of 51
$138
AK $282FL $87.10
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.