How much rates vary
Facilitymedian $447 · 10th to 90th $138 to $3,311Professionalmedian $447 · 10th to 90th $209 to $1,820
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 $691.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $691.83 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $562.34 | Professional | None | $199.53 | $295.12 | $562.34 |
AllWays Health Partners Setting Facility Modifier None Typical Low $426.58 Median $1,318.26 Typical High $3,890.45 | Facility | None | $426.58 | $1,318.26 | $3,890.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $218.78 Median $512.86 Typical High $2,454.71 | Professional | None | $218.78 | $512.86 | $2,454.71 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $436.52 | Facility | None | $190.55 | $229.09 | $436.52 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $251.19 Median $616.60 Typical High $1,288.25 | Professional | None | $251.19 | $616.60 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $588.84 Typical High $776.25 | Facility | None | $467.74 | $588.84 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $851.14 | Professional | None | $263.03 | $467.74 | $851.14 |
Fallon Health Setting Facility Modifier None Typical Low $109.65 Median $218.78 Typical High $1,905.46 | Facility | None | $109.65 | $218.78 | $1,905.46 |
Fallon Health Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $537.03 | Professional | None | $208.93 | $371.54 | $537.03 |
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 $208.93 Median $457.09 Typical High $977.24 | Professional | None | $208.93 | $457.09 | $977.24 |
Mass General Brigham Setting Facility Modifier None Typical Low $426.58 Median $1,318.26 Typical High $3,890.45 | Facility | None | $426.58 | $1,318.26 | $3,890.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $218.78 Median $512.86 Typical High $2,454.71 | Professional | None | $218.78 | $512.86 | $2,454.71 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,348.96 Typical High $5,128.61 | Facility | None | $575.44 | $1,348.96 | $5,128.61 |
United Setting Professional Modifier None Typical Low $229.09 Median $446.68 Typical High $1,047.13 | Professional | None | $229.09 | $446.68 | $1,047.13 |
Well Sense Setting Facility Modifier None Typical Low $169.82 Median $281.84 Typical High $537.03 | Facility | None | $169.82 | $281.84 | $537.03 |
Well Sense Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $269.15 | Professional | None | $151.36 | $181.97 | $269.15 |
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 $100.00 Median $147.91 Typical High $309.03 | Professional | 52 · Reduced service | $100.00 | $147.91 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $58.88 Typical High $123.03 | Professional | 53 · Discontinued | $40.74 | $58.88 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $218.78 Typical High $457.09 | Professional | 54 · Surgery only | $151.36 | $218.78 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $43.65 Typical High $91.20 | Professional | 55 · Aftercare only | $30.20 | $43.65 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $29.51 Typical High $61.66 | Professional | 56 · Pre-op care only | $19.95 | $29.51 | $61.66 |
Where Massachusetts sits
The same service costs 3.0 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
$447
WI $891KY $295
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.