How much rates vary
Facilitymedian $105 · 10th to 90th $38 to $1,862Professionalmedian $132 · 10th to 90th $59 to $501
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 $380.19 Median $2,187.76 Typical High $3,630.78 | Facility | None | $380.19 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $213.80 | Professional | None | $53.70 | $97.72 | $213.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $52.48 Median $309.03 Typical High $1,862.09 | Facility | None | $52.48 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $67.61 Median $151.36 Typical High $758.58 | Professional | None | $67.61 | $151.36 | $758.58 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $123.03 | Facility | None | $52.48 | $52.48 | $123.03 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $52.48 Median $120.23 Typical High $309.03 | Professional | None | $52.48 | $120.23 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $128.82 Typical High $489.78 | Facility | None | $100.00 | $128.82 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $138.04 Typical High $245.47 | Professional | None | $70.79 | $138.04 | $245.47 |
Fallon Health Setting Facility Modifier None Typical Low $30.20 Median $60.26 Typical High $218.78 | Facility | None | $30.20 | $60.26 | $218.78 |
Fallon Health Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $165.96 | Professional | None | $66.07 | $114.82 | $165.96 |
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 $58.88 Median $131.83 Typical High $288.40 | Professional | None | $58.88 | $131.83 | $288.40 |
Health New England Setting Facility Modifier None Typical Low $295.12 Median $616.60 Typical High $660.69 | Facility | None | $295.12 | $616.60 | $660.69 |
Health New England Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $52.48 Median $309.03 Typical High $1,862.09 | Facility | None | $52.48 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $67.61 Median $151.36 Typical High $758.58 | Professional | None | $67.61 | $151.36 | $758.58 |
Tufts Setting Facility Modifier None Typical Low $144.54 Median $416.87 Typical High $741.31 | Facility | None | $144.54 | $416.87 | $741.31 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $67.61 Median $138.04 Typical High $295.12 | Professional | None | $67.61 | $138.04 | $295.12 |
Well Sense Setting Facility Modifier None Typical Low $45.71 Median $67.61 Typical High $112.20 | Facility | None | $45.71 | $67.61 | $112.20 |
Well Sense Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $107.15 | Professional | None | $52.48 | $63.10 | $107.15 |
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 $26.92 Median $48.98 Typical High $107.15 | Professional | 52 · Reduced service | $26.92 | $48.98 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $19.50 Typical High $42.66 | Professional | 53 · Discontinued | $10.72 | $19.50 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $72.44 Typical High $158.49 | Professional | 54 · Surgery only | $39.81 | $72.44 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $14.79 Typical High $32.36 | Professional | 55 · Aftercare only | $8.13 | $14.79 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $9.77 Typical High $21.38 | Professional | 56 · Pre-op care only | $5.37 | $9.77 | $21.38 |
Where Massachusetts sits
The same service costs 2.8 times more in Wisconsin 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· 12th of 51
$129
WI $257KY $91.20
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.