How much rates vary
Facilitymedian $1,047 · 10th to 90th $89 to $5,248Professionalmedian $191 · 10th to 90th $98 to $1,072
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 $2,570.40 Median $3,090.30 Typical High $6,309.57 | Facility | None | $2,570.40 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $295.12 | Professional | None | $107.15 | $107.15 | $295.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $630.96 Median $1,819.70 Typical High $5,248.07 | Facility | None | $630.96 | $1,819.70 | $5,248.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $144.54 Median $331.13 Typical High $1,071.52 | Professional | None | $144.54 | $331.13 | $1,071.52 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $436.52 | Professional | None | $131.83 | $263.03 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,290.87 Typical High $3,388.44 | Facility | None | $446.68 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $363.08 | Professional | None | $151.36 | $151.36 | $363.08 |
Fallon Health Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $2,818.38 | Facility | None | $75.86 | $151.36 | $2,818.38 |
Fallon Health Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $190.55 | Professional | None | $72.44 | $131.83 | $190.55 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $144.54 Median $263.03 Typical High $457.09 | Professional | None | $144.54 | $263.03 | $457.09 |
Mass General Brigham Setting Facility Modifier None Typical Low $630.96 Median $1,819.70 Typical High $5,248.07 | Facility | None | $630.96 | $1,819.70 | $5,248.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $144.54 Median $331.13 Typical High $1,071.52 | Professional | None | $144.54 | $331.13 | $1,071.52 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $457.09 | Professional | None | $147.91 | $199.53 | $457.09 |
Well Sense Setting Facility Modifier None Typical Low $107.15 Median $169.82 Typical High $1,047.13 | Facility | None | $107.15 | $169.82 | $1,047.13 |
Well Sense Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | None | $95.50 | $95.50 | $114.82 |
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 $53.70 Median $53.70 Typical High $190.55 | Professional | 52 · Reduced service | $53.70 | $53.70 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $75.86 | Professional | 53 · Discontinued | $21.38 | $21.38 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $288.40 | Professional | 54 · Surgery only | $81.28 | $81.28 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $57.54 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $38.02 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $38.02 |
Where Massachusetts sits
The same service costs 10.7 times more in Oklahoma than in New York. 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· 29th of 51
$204
OK $1,413NY $132
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.