How much rates vary
Facilitymedian $501 · 10th to 90th $110 to $3,631Professionalmedian $398 · 10th to 90th $166 to $1,698
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 $288.40 Median $2,691.53 Typical High $3,630.78 | Facility | None | $288.40 | $2,691.53 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $489.78 | Professional | None | $158.49 | $288.40 | $489.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $436.52 Median $1,318.26 Typical High $3,890.45 | Facility | None | $436.52 | $1,318.26 | $3,890.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $169.82 Median $489.78 Typical High $3,890.45 | Professional | None | $169.82 | $489.78 | $3,890.45 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $151.36 Median $181.97 Typical High $346.74 | Facility | None | $151.36 | $181.97 | $346.74 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $199.53 Median $512.86 Typical High $1,202.26 | Professional | None | $199.53 | $512.86 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,318.26 Typical High $1,949.84 | Facility | None | $588.84 | $1,318.26 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $436.52 Typical High $794.33 | Professional | None | $204.17 | $436.52 | $794.33 |
Fallon Health Setting Facility Modifier None Typical Low $87.10 Median $173.78 Typical High $1,905.46 | Facility | None | $87.10 | $173.78 | $1,905.46 |
Fallon Health Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $512.86 | Professional | None | $204.17 | $354.81 | $512.86 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $5,128.61 | Facility | None | $549.54 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $165.96 Median $389.05 Typical High $933.25 | Professional | None | $165.96 | $389.05 | $933.25 |
Health New England Setting Facility Modifier None Typical Low $954.99 Median $4,073.80 Typical High $5,248.07 | Facility | None | $954.99 | $4,073.80 | $5,248.07 |
Health New England Setting Professional Modifier None Typical Low $269.15 Median $602.56 Typical High $616.60 | Professional | None | $269.15 | $602.56 | $616.60 |
Mass General Brigham Setting Facility Modifier None Typical Low $436.52 Median $1,318.26 Typical High $3,890.45 | Facility | None | $436.52 | $1,318.26 | $3,890.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $169.82 Median $489.78 Typical High $3,890.45 | Professional | None | $169.82 | $489.78 | $3,890.45 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,918.31 | Facility | None | $575.44 | $1,380.38 | $6,918.31 |
United Setting Professional Modifier None Typical Low $190.55 Median $436.52 Typical High $1,000.00 | Professional | None | $190.55 | $436.52 | $1,000.00 |
Well Sense Setting Facility Modifier None Typical Low $131.83 Median $281.84 Typical High $676.08 | Facility | None | $131.83 | $281.84 | $676.08 |
Well Sense Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $288.40 | Professional | None | $120.23 | $144.54 | $288.40 |
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 $77.62 Median $144.54 Typical High $245.47 | Professional | 52 · Reduced service | $77.62 | $144.54 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $57.54 Typical High $97.72 | Professional | 53 · Discontinued | $31.62 | $57.54 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $218.78 Typical High $371.54 | Professional | 54 · Surgery only | $117.49 | $218.78 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $43.65 Typical High $74.13 | Professional | 55 · Aftercare only | $23.44 | $43.65 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $28.84 Typical High $48.98 | Professional | 56 · Pre-op care only | $15.85 | $28.84 | $48.98 |
Where Massachusetts sits
The same service costs 3.0 times more in Wisconsin than in Utah. 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· 17th of 51
$407
WI $851UT $288
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.