How much rates vary
Facilitymedian $135 · 10th to 90th $54 to $1,862Professionalmedian $174 · 10th to 90th $93 to $617
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 $338.84 Median $2,187.76 Typical High $3,630.78 | Facility | None | $338.84 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $234.42 | Professional | None | $93.33 | $120.23 | $234.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $58.88 Median $363.08 Typical High $1,819.70 | Facility | None | $58.88 | $363.08 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $102.33 Median $223.87 Typical High $1,023.29 | Professional | None | $102.33 | $223.87 | $1,023.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $204.17 | Facility | None | $89.13 | $89.13 | $204.17 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $281.84 | Professional | None | $89.13 | $158.49 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $144.54 Typical High $630.96 | Facility | None | $102.33 | $144.54 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $354.81 | Professional | None | $102.33 | $158.49 | $354.81 |
Fallon Health Setting Facility Modifier None Typical Low $51.29 Median $97.72 Typical High $257.04 | Facility | None | $51.29 | $97.72 | $257.04 |
Fallon Health Setting Professional Modifier None Typical Low $87.10 Median $154.88 Typical High $223.87 | Professional | None | $87.10 | $154.88 | $223.87 |
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 $100.00 Median $199.53 Typical High $398.11 | Professional | None | $100.00 | $199.53 | $398.11 |
Health New England Setting Facility Modifier None Typical Low $165.96 Median $478.63 Typical High $3,235.94 | Facility | None | $165.96 | $478.63 | $3,235.94 |
Health New England Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $58.88 Median $363.08 Typical High $1,819.70 | Facility | None | $58.88 | $363.08 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $102.33 Median $223.87 Typical High $1,023.29 | Professional | None | $102.33 | $223.87 | $1,023.29 |
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 $114.82 Median $173.78 Typical High $398.11 | Professional | None | $114.82 | $173.78 | $398.11 |
Well Sense Setting Facility Modifier None Typical Low $53.70 Median $102.33 Typical High $154.88 | Facility | None | $53.70 | $102.33 | $154.88 |
Well Sense Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $102.33 | Professional | None | $64.57 | $77.62 | $102.33 |
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 $46.77 Median $60.26 Typical High $128.82 | Professional | 52 · Reduced service | $46.77 | $60.26 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $24.55 Typical High $51.29 | Professional | 53 · Discontinued | $18.62 | $24.55 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $91.20 Typical High $190.55 | Professional | 54 · Surgery only | $69.18 | $91.20 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $18.20 Typical High $38.02 | Professional | 55 · Aftercare only | $13.80 | $18.20 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.02 Typical High $25.70 | Professional | 56 · Pre-op care only | $9.33 | $12.02 | $25.70 |
Where Massachusetts sits
The same service costs 3.3 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· 14th of 51
$174
WI $372KY $112
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.