How much rates vary
Facilitymedian $129 · 10th to 90th $51 to $1,862Professionalmedian $191 · 10th to 90th $78 to $851
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 $389.05 Median $2,187.76 Typical High $3,630.78 | Facility | None | $389.05 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $229.09 | Professional | None | $74.13 | $114.82 | $229.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $75.86 Median $354.81 Typical High $1,819.70 | Facility | None | $75.86 | $354.81 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $81.28 Median $218.78 Typical High $1,230.27 | Professional | None | $81.28 | $218.78 | $1,230.27 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $165.96 | Facility | None | $70.79 | $70.79 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $218.78 Typical High $489.78 | Facility | None | $100.00 | $218.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $229.09 Typical High $416.87 | Professional | None | $95.50 | $229.09 | $416.87 |
Fallon Health Setting Facility Modifier None Typical Low $40.74 Median $79.43 Typical High $218.78 | Facility | None | $40.74 | $79.43 | $218.78 |
Fallon Health Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $275.42 | Professional | None | $109.65 | $190.55 | $275.42 |
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 $77.62 Median $194.98 Typical High $478.63 | Professional | None | $77.62 | $194.98 | $478.63 |
Mass General Brigham Setting Facility Modifier None Typical Low $75.86 Median $354.81 Typical High $1,819.70 | Facility | None | $75.86 | $354.81 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $81.28 Median $218.78 Typical High $1,230.27 | Professional | None | $81.28 | $218.78 | $1,230.27 |
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 $85.11 Median $186.21 Typical High $489.78 | Professional | None | $85.11 | $186.21 | $489.78 |
Well Sense Setting Facility Modifier None Typical Low $61.66 Median $95.50 Typical High $190.55 | Facility | None | $61.66 | $95.50 | $190.55 |
Well Sense Setting Professional Modifier None Typical Low $56.23 Median $67.61 Typical High $109.65 | Professional | None | $56.23 | $67.61 | $109.65 |
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 $57.54 Typical High $114.82 | Professional | 52 · Reduced service | $37.15 | $57.54 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $22.91 Typical High $45.71 | Professional | 53 · Discontinued | $14.79 | $22.91 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $87.10 Typical High $173.78 | Professional | 54 · Surgery only | $54.95 | $87.10 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $17.38 Typical High $34.67 | Professional | 55 · Aftercare only | $10.96 | $17.38 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $11.48 Typical High $22.91 | Professional | 56 · Pre-op care only | $7.41 | $11.48 | $22.91 |
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· 12th of 51
$182
WI $380KY $105
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.