How much rates vary
Facilitymedian $56 · 10th to 90th $18 to $1,122Professionalmedian $66 · 10th to 90th $29 to $282
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 $28.84 Median $46.77 Typical High $151.36 | Facility | None | $28.84 | $46.77 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $46.77 Typical High $85.11 | Professional | None | $28.84 | $46.77 | $85.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $234.42 Typical High $1,862.09 | Facility | None | $50.12 | $234.42 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $33.11 Median $85.11 Typical High $416.87 | Professional | None | $33.11 | $85.11 | $416.87 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $57.54 | Facility | None | $24.55 | $24.55 | $57.54 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $32.36 Median $77.62 Typical High $186.21 | Professional | None | $32.36 | $77.62 | $186.21 |
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 $28.84 Median $67.61 Typical High $151.36 | Professional | None | $28.84 | $67.61 | $151.36 |
Fallon Health Setting Facility Modifier None Typical Low $14.13 Median $28.18 Typical High $218.78 | Facility | None | $14.13 | $28.18 | $218.78 |
Fallon Health Setting Professional Modifier None Typical Low $34.67 Median $60.26 Typical High $87.10 | Professional | None | $34.67 | $60.26 | $87.10 |
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 $30.20 Median $64.57 Typical High $162.18 | Professional | None | $30.20 | $64.57 | $162.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $234.42 Typical High $1,862.09 | Facility | None | $50.12 | $234.42 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $33.11 Median $85.11 Typical High $416.87 | Professional | None | $33.11 | $85.11 | $416.87 |
United Setting Facility Modifier None Typical Low $87.10 Median $524.81 Typical High $2,754.23 | Facility | None | $87.10 | $524.81 | $2,754.23 |
United Setting Professional Modifier None Typical Low $34.67 Median $72.44 Typical High $173.78 | Professional | None | $34.67 | $72.44 | $173.78 |
Well Sense Setting Facility Modifier None Typical Low $22.91 Median $43.65 Typical High $72.44 | Facility | None | $22.91 | $43.65 | $72.44 |
Well Sense Setting Professional Modifier None Typical Low $21.38 Median $25.70 Typical High $44.67 | Professional | None | $21.38 | $25.70 | $44.67 |
4 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 $14.45 Median $23.44 Typical High $41.69 | Professional | 52 · Reduced service | $14.45 | $23.44 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $9.33 Typical High $16.98 | Professional | 53 · Discontinued | $5.75 | $9.33 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $7.08 Typical High $12.59 | Professional | 55 · Aftercare only | $4.37 | $7.08 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $4.68 Typical High $8.51 | Professional | 56 · Pre-op care only | $2.88 | $4.68 | $8.51 |
Where Massachusetts sits
The same service costs 3.5 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· 14th of 51
$66.07
WI $135UT $38.02
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.