How much rates vary
Facilitymedian $240 · 10th to 90th $148 to $2,818Professionalmedian $427 · 10th to 90th $182 to $2,512
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $380.19 | Professional | None | $181.97 | $323.59 | $380.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,023.29 Typical High $3,548.13 | Facility | None | $346.74 | $1,023.29 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $169.82 Median $524.81 Typical High $2,511.89 | Professional | None | $169.82 | $524.81 | $2,511.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $346.74 | Facility | None | $147.91 | $147.91 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $758.58 | Professional | None | $194.98 | $371.54 | $758.58 |
Fallon Health Setting Facility Modifier None Typical Low $147.91 Median $190.55 Typical High $3,311.31 | Facility | None | $147.91 | $190.55 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $691.83 | Professional | None | $416.87 | $512.86 | $691.83 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $165.96 Median $407.38 Typical High $954.99 | Professional | None | $165.96 | $407.38 | $954.99 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,023.29 Typical High $3,548.13 | Facility | None | $346.74 | $1,023.29 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $169.82 Median $524.81 Typical High $2,511.89 | Professional | None | $169.82 | $524.81 | $2,511.89 |
United Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $190.55 Median $407.38 Typical High $933.25 | Professional | None | $190.55 | $407.38 | $933.25 |
Well Sense Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $407.38 | Facility | None | $125.89 | $251.19 | $407.38 |
Well Sense Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $275.42 | Professional | None | $117.49 | $141.25 | $275.42 |
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 $91.20 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $91.20 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $64.57 Typical High $75.86 | Professional | 53 · Discontinued | $36.31 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $239.88 Typical High $281.84 | Professional | 54 · Surgery only | $134.90 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $26.92 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.20 | $31.62 | $38.02 |
Where Massachusetts sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 11th of 51
$407
AK $661VA $186
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.