How much rates vary
Facilitymedian $302 · 10th to 90th $59 to $2,399Professionalmedian $191 · 10th to 90th $89 to $1,288
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 $524.81 Median $2,187.76 Typical High $3,630.78 | Facility | None | $524.81 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $251.19 | Professional | None | $83.18 | $138.04 | $251.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $239.88 Median $602.56 Typical High $2,089.30 | Facility | None | $239.88 | $602.56 | $2,089.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $100.00 Median $229.09 Typical High $1,819.70 | Professional | None | $100.00 | $229.09 | $1,819.70 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $81.28 Median $100.00 Typical High $186.21 | Facility | None | $81.28 | $100.00 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $489.78 Typical High $630.96 | Facility | None | $446.68 | $489.78 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $346.74 | Professional | None | $107.15 | $190.55 | $346.74 |
Fallon Health Setting Facility Modifier None Typical Low $46.77 Median $93.33 Typical High $1,412.54 | Facility | None | $46.77 | $93.33 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $234.42 | Professional | None | $91.20 | $158.49 | $234.42 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $89.13 Median $199.53 Typical High $398.11 | Professional | None | $89.13 | $199.53 | $398.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $239.88 Median $602.56 Typical High $2,089.30 | Facility | None | $239.88 | $602.56 | $2,089.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $100.00 Median $229.09 Typical High $1,819.70 | Professional | None | $100.00 | $229.09 | $1,819.70 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $102.33 Median $199.53 Typical High $416.87 | Professional | None | $102.33 | $199.53 | $416.87 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $134.90 Typical High $288.40 | Facility | None | $70.79 | $134.90 | $288.40 |
Well Sense Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $151.36 | Professional | None | $74.13 | $89.13 | $151.36 |
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 $41.69 Median $69.18 Typical High $151.36 | Professional | 52 · Reduced service | $41.69 | $69.18 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $27.54 Typical High $60.26 | Professional | 53 · Discontinued | $16.60 | $27.54 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $102.33 Typical High $229.09 | Professional | 54 · Surgery only | $61.66 | $102.33 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $20.42 Typical High $45.71 | Professional | 55 · Aftercare only | $12.59 | $20.42 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.80 Typical High $30.20 | Professional | 56 · Pre-op care only | $8.32 | $13.80 | $30.20 |
Where Massachusetts sits
The same service costs 3.6 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· 15th of 51
$191
WI $417KY $115
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.