How much rates vary
Facilitymedian $69 · 10th to 90th $29 to $1,820Professionalmedian $95 · 10th to 90th $49 to $355
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 $79.43 Median $2,691.53 Typical High $5,128.61 | Facility | None | $79.43 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $79.43 Typical High $134.90 | Professional | None | $47.86 | $79.43 | $134.90 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $257.04 Typical High $1,862.09 | Facility | None | $50.12 | $257.04 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $57.54 Median $117.49 Typical High $524.81 | Professional | None | $57.54 | $117.49 | $524.81 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $102.33 | Facility | None | $43.65 | $43.65 | $102.33 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $43.65 Median $107.15 Typical High $239.88 | Professional | None | $43.65 | $107.15 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $69.18 Typical High $100.00 | Facility | None | $48.98 | $69.18 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $186.21 | Professional | None | $52.48 | $89.13 | $186.21 |
Fallon Health Setting Facility Modifier None Typical Low $25.12 Median $50.12 Typical High $218.78 | Facility | None | $25.12 | $50.12 | $218.78 |
Fallon Health Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $114.82 | Professional | None | $44.67 | $79.43 | $114.82 |
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 $52.48 Median $107.15 Typical High $208.93 | Professional | None | $52.48 | $107.15 | $208.93 |
Health New England Setting Facility Modifier None Typical Low $234.42 Median $407.38 Typical High $436.52 | Facility | None | $234.42 | $407.38 | $436.52 |
Health New England Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $154.88 | Professional | None | $131.83 | $134.90 | $154.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $257.04 Typical High $1,862.09 | Facility | None | $50.12 | $257.04 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $57.54 Median $117.49 Typical High $524.81 | Professional | None | $57.54 | $117.49 | $524.81 |
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 $60.26 Median $100.00 Typical High $218.78 | Professional | None | $60.26 | $100.00 | $218.78 |
Well Sense Setting Facility Modifier None Typical Low $28.84 Median $52.48 Typical High $85.11 | Facility | None | $28.84 | $52.48 | $85.11 |
Well Sense Setting Professional Modifier None Typical Low $34.67 Median $41.69 Typical High $69.18 | Professional | None | $34.67 | $41.69 | $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 $23.44 Median $39.81 Typical High $67.61 | Professional | 52 · Reduced service | $23.44 | $39.81 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.85 Typical High $26.92 | Professional | 53 · Discontinued | $9.55 | $15.85 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $60.26 Typical High $102.33 | Professional | 54 · Surgery only | $35.48 | $60.26 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.02 Typical High $20.42 | Professional | 55 · Aftercare only | $7.08 | $12.02 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.94 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.79 | $7.94 | $13.49 |
Where Massachusetts sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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
$93.33
WI $200DC $64.57
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.