How much rates vary
Facilitymedian $93 · 10th to 90th $39 to $1,820Professionalmedian $123 · 10th to 90th $60 to $437
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 $89.13 Median $2,691.53 Typical High $5,128.61 | Facility | None | $89.13 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $158.49 | Professional | None | $58.88 | $89.13 | $158.49 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $295.12 Typical High $1,862.09 | Facility | None | $50.12 | $295.12 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $691.83 | Professional | None | $69.18 | $144.54 | $691.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $53.70 Median $64.57 Typical High $123.03 | Facility | None | $53.70 | $64.57 | $123.03 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $53.70 Median $107.15 Typical High $234.42 | Professional | None | $53.70 | $107.15 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $100.00 Typical High $489.78 | Facility | None | $77.62 | $100.00 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $107.15 Typical High $229.09 | Professional | None | $64.57 | $107.15 | $229.09 |
Fallon Health Setting Facility Modifier None Typical Low $30.90 Median $61.66 Typical High $263.03 | Facility | None | $30.90 | $61.66 | $263.03 |
Fallon Health Setting Professional Modifier None Typical Low $58.88 Median $104.71 Typical High $151.36 | Professional | None | $58.88 | $104.71 | $151.36 |
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 $66.07 Median $131.83 Typical High $263.03 | Professional | None | $66.07 | $131.83 | $263.03 |
Health New England Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $295.12 Typical High $1,862.09 | Facility | None | $50.12 | $295.12 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $691.83 | Professional | None | $69.18 | $144.54 | $691.83 |
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 $75.86 Median $123.03 Typical High $269.15 | Professional | None | $75.86 | $123.03 | $269.15 |
Well Sense Setting Facility Modifier None Typical Low $38.90 Median $69.18 Typical High $104.71 | Facility | None | $38.90 | $69.18 | $104.71 |
Well Sense Setting Professional Modifier None Typical Low $42.66 Median $51.29 Typical High $77.62 | Professional | None | $42.66 | $51.29 | $77.62 |
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 $29.51 Median $44.67 Typical High $83.18 | Professional | 52 · Reduced service | $29.51 | $44.67 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $17.78 Typical High $33.11 | Professional | 53 · Discontinued | $11.75 | $17.78 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $66.07 Typical High $125.89 | Professional | 54 · Surgery only | $43.65 | $66.07 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $13.18 Typical High $25.12 | Professional | 55 · Aftercare only | $8.71 | $13.18 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.91 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.89 | $8.91 | $16.60 |
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· 15th of 51
$120
WI $240DC $77.62
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.