How much rates vary
Facilitymedian $214 · 10th to 90th $87 to $2,455Professionalmedian $257 · 10th to 90th $145 to $1,380
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $457.09 | Professional | None | $144.54 | $177.83 | $457.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $275.42 Median $724.44 Typical High $2,454.71 | Facility | None | $275.42 | $724.44 | $2,454.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $147.91 Median $346.74 Typical High $1,380.38 | Professional | None | $147.91 | $346.74 | $1,380.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $323.59 | Facility | None | $141.25 | $141.25 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $169.82 Typical High $489.78 | Facility | None | $100.00 | $169.82 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $489.78 | Professional | None | $190.55 | $245.47 | $489.78 |
Fallon Health Setting Facility Modifier None Typical Low $81.28 Median $154.88 Typical High $346.74 | Facility | None | $81.28 | $154.88 | $346.74 |
Fallon Health Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $302.00 | Professional | None | $117.49 | $208.93 | $302.00 |
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 $154.88 Median $309.03 Typical High $575.44 | Professional | None | $154.88 | $309.03 | $575.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $275.42 Median $724.44 Typical High $2,454.71 | Facility | None | $275.42 | $724.44 | $2,454.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $147.91 Median $346.74 Typical High $1,380.38 | Professional | None | $147.91 | $346.74 | $1,380.38 |
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 $158.49 Median $257.04 Typical High $588.84 | Professional | None | $158.49 | $257.04 | $588.84 |
Well Sense Setting Facility Modifier None Typical Low $66.07 Median $144.54 Typical High $239.88 | Facility | None | $66.07 | $144.54 | $239.88 |
Well Sense Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $165.96 | Professional | None | $112.20 | $134.90 | $165.96 |
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 $72.44 Median $89.13 Typical High $229.09 | Professional | 52 · Reduced service | $72.44 | $89.13 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $36.31 Typical High $91.20 | Professional | 53 · Discontinued | $28.84 | $36.31 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $134.90 Typical High $338.84 | Professional | 54 · Surgery only | $107.15 | $134.90 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $26.92 Typical High $67.61 | Professional | 55 · Aftercare only | $21.38 | $26.92 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $17.78 Typical High $45.71 | Professional | 56 · Pre-op care only | $14.45 | $17.78 | $45.71 |
Where Massachusetts sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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
$257
AK $575PA $170
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.