How much rates vary
Facilitymedian $74 · 10th to 90th $29 to $1,862Professionalmedian $98 · 10th to 90th $44 to $389
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 $74.13 Median $2,691.53 Typical High $5,128.61 | Facility | None | $74.13 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $74.13 Typical High $128.82 | Professional | None | $41.69 | $74.13 | $128.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $52.48 Median $234.42 Typical High $1,819.70 | Facility | None | $52.48 | $234.42 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $45.71 Median $109.65 Typical High $977.24 | Professional | None | $45.71 | $109.65 | $977.24 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $93.33 | Facility | None | $39.81 | $39.81 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $100.00 | Facility | None | $50.12 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $104.71 Typical High $186.21 | Professional | None | $53.70 | $104.71 | $186.21 |
Fallon Health Setting Facility Modifier None Typical Low $22.91 Median $45.71 Typical High $218.78 | Facility | None | $22.91 | $45.71 | $218.78 |
Fallon Health Setting Professional Modifier None Typical Low $50.12 Median $89.13 Typical High $128.82 | Professional | None | $50.12 | $89.13 | $128.82 |
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 $43.65 Median $97.72 Typical High $218.78 | Professional | None | $43.65 | $97.72 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $52.48 Median $234.42 Typical High $1,819.70 | Facility | None | $52.48 | $234.42 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $45.71 Median $109.65 Typical High $977.24 | Professional | None | $45.71 | $109.65 | $977.24 |
United Setting Facility Modifier None Typical Low $123.03 Median $524.81 Typical High $2,754.23 | Facility | None | $123.03 | $524.81 | $2,754.23 |
United Setting Professional Modifier None Typical Low $48.98 Median $97.72 Typical High $229.09 | Professional | None | $48.98 | $97.72 | $229.09 |
Well Sense Setting Facility Modifier None Typical Low $35.48 Median $57.54 Typical High $89.13 | Facility | None | $35.48 | $57.54 | $89.13 |
Well Sense Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $69.18 | Professional | None | $31.62 | $38.02 | $69.18 |
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 $20.89 Median $37.15 Typical High $64.57 | Professional | 52 · Reduced service | $20.89 | $37.15 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $14.79 Typical High $25.70 | Professional | 53 · Discontinued | $8.32 | $14.79 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $54.95 Typical High $95.50 | Professional | 54 · Surgery only | $30.90 | $54.95 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.96 Typical High $19.05 | Professional | 55 · Aftercare only | $6.17 | $10.96 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $7.41 Typical High $12.88 | Professional | 56 · Pre-op care only | $4.17 | $7.41 | $12.88 |
Where Massachusetts sits
The same service costs 3.4 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· 16th of 51
$95.50
WI $209KY $61.66
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.