How much rates vary
Facilitymedian $178 · 10th to 90th $55 to $2,455Professionalmedian $182 · 10th to 90th $83 to $724
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 $407.38 Median $2,187.76 Typical High $3,630.78 | Facility | None | $407.38 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $134.90 Typical High $223.87 | Professional | None | $77.62 | $134.90 | $223.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $169.82 Median $724.44 Typical High $2,454.71 | Facility | None | $169.82 | $724.44 | $2,454.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $85.11 Median $218.78 Typical High $1,122.02 | Professional | None | $85.11 | $218.78 | $1,122.02 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $75.86 Median $93.33 Typical High $173.78 | Facility | None | $75.86 | $93.33 | $173.78 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $75.86 Median $177.83 Typical High $407.38 | Professional | None | $75.86 | $177.83 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $199.53 Typical High $489.78 | Facility | None | $100.00 | $199.53 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $181.97 Typical High $398.11 | Professional | None | $87.10 | $181.97 | $398.11 |
Fallon Health Setting Facility Modifier None Typical Low $43.65 Median $85.11 Typical High $218.78 | Facility | None | $43.65 | $85.11 | $218.78 |
Fallon Health Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $251.19 | Professional | None | $100.00 | $173.78 | $251.19 |
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 $83.18 Median $190.55 Typical High $436.52 | Professional | None | $83.18 | $190.55 | $436.52 |
Health New England Setting Facility Modifier None Typical Low $162.18 Median $776.25 Typical High $851.14 | Facility | None | $162.18 | $776.25 | $851.14 |
Health New England Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $323.59 | Professional | None | $275.42 | $295.12 | $323.59 |
Mass General Brigham Setting Facility Modifier None Typical Low $169.82 Median $724.44 Typical High $2,454.71 | Facility | None | $169.82 | $724.44 | $2,454.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $85.11 Median $218.78 Typical High $1,122.02 | Professional | None | $85.11 | $218.78 | $1,122.02 |
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 $89.13 Median $199.53 Typical High $467.74 | Professional | None | $89.13 | $199.53 | $467.74 |
Well Sense Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $181.97 | Facility | None | $66.07 | $102.33 | $181.97 |
Well Sense Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $117.49 | Professional | None | $54.95 | $66.07 | $117.49 |
7 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 $38.90 Median $67.61 Typical High $107.15 | Professional | 52 · Reduced service | $38.90 | $67.61 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $26.92 Typical High $42.66 | Professional | 53 · Discontinued | $15.49 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $102.33 Typical High $162.18 | Professional | 54 · Surgery only | $57.54 | $102.33 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $20.42 Typical High $32.36 | Professional | 55 · Aftercare only | $11.75 | $20.42 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $13.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $7.76 | $13.49 | $21.38 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $154.88 Typical High $251.19 | Professional | 52 · Reduced service | $89.13 | $154.88 | $251.19 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $63.10 Typical High $117.49 | Professional | 53 · Discontinued | $26.92 | $63.10 | $117.49 |
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· 13th of 51
$182
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.