How much rates vary
Facilitymedian $204 · 10th to 90th $74 to $2,455Professionalmedian $240 · 10th to 90th $126 to $851
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 $457.09 Median $2,187.76 Typical High $3,630.78 | Facility | None | $457.09 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $309.03 | Professional | None | $125.89 | $162.18 | $309.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $263.03 Median $724.44 Typical High $2,089.30 | Facility | None | $263.03 | $724.44 | $2,089.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $134.90 Median $302.00 Typical High $1,348.96 | Professional | None | $134.90 | $302.00 | $1,348.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $275.42 | Facility | None | $120.23 | $120.23 | $275.42 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $478.63 | Professional | None | $120.23 | $208.93 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $186.21 Typical High $630.96 | Facility | None | $128.82 | $186.21 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $446.68 | Professional | None | $138.04 | $208.93 | $446.68 |
Fallon Health Setting Facility Modifier None Typical Low $67.61 Median $131.83 Typical High $302.00 | Facility | None | $67.61 | $131.83 | $302.00 |
Fallon Health Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $295.12 | Professional | None | $114.82 | $204.17 | $295.12 |
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 $138.04 Median $269.15 Typical High $537.03 | Professional | None | $138.04 | $269.15 | $537.03 |
Health New England Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $1,288.25 | Facility | None | $144.54 | $144.54 | $1,288.25 |
Health New England Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Mass General Brigham Setting Facility Modifier None Typical Low $263.03 Median $724.44 Typical High $2,089.30 | Facility | None | $263.03 | $724.44 | $2,089.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $134.90 Median $302.00 Typical High $1,348.96 | Professional | None | $134.90 | $302.00 | $1,348.96 |
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 $234.42 Typical High $537.03 | Professional | None | $158.49 | $234.42 | $537.03 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $134.90 Typical High $208.93 | Facility | None | $70.79 | $134.90 | $208.93 |
Well Sense Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $138.04 | Professional | None | $89.13 | $107.15 | $138.04 |
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 $61.66 Median $81.28 Typical High $173.78 | Professional | 52 · Reduced service | $61.66 | $81.28 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $69.18 | Professional | 53 · Discontinued | $25.12 | $32.36 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $120.23 Typical High $263.03 | Professional | 54 · Surgery only | $93.33 | $120.23 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $24.55 Typical High $52.48 | Professional | 55 · Aftercare only | $18.62 | $24.55 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $34.67 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $34.67 |
Where Massachusetts sits
The same service costs 3.7 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· 15th of 51
$240
WI $501KY $135
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.