How much rates vary
Facilitymedian $200 · 10th to 90th $112 to $3,388Professionalmedian $309 · 10th to 90th $129 to $1,259
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $263.03 | Professional | None | $128.82 | $218.78 | $263.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $331.13 Median $1,412.54 Typical High $4,168.69 | Facility | None | $331.13 | $1,412.54 | $4,168.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $131.83 Median $363.08 Typical High $2,630.27 | Professional | None | $131.83 | $363.08 | $2,630.27 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $263.03 | Facility | None | $112.20 | $112.20 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $309.03 Typical High $616.60 | Professional | None | $162.18 | $309.03 | $616.60 |
Fallon Health Setting Facility Modifier None Typical Low $114.82 Median $141.25 Typical High $3,311.31 | Facility | None | $114.82 | $141.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $501.19 | Professional | None | $302.00 | $363.08 | $501.19 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $7,244.36 | Facility | None | $1,318.26 | $2,511.89 | $7,244.36 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $125.89 Median $295.12 Typical High $741.31 | Professional | None | $125.89 | $295.12 | $741.31 |
Health New England Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $331.13 Median $1,412.54 Typical High $4,168.69 | Facility | None | $331.13 | $1,412.54 | $4,168.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $131.83 Median $363.08 Typical High $2,630.27 | Professional | None | $131.83 | $363.08 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $2,511.89 Typical High $6,309.57 | Facility | None | $1,148.15 | $2,511.89 | $6,309.57 |
United Setting Professional Modifier None Typical Low $147.91 Median $323.59 Typical High $776.25 | Professional | None | $147.91 | $323.59 | $776.25 |
Well Sense Setting Facility Modifier None Typical Low $102.33 Median $199.53 Typical High $338.84 | Facility | None | $102.33 | $199.53 | $338.84 |
Well Sense Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $213.80 | Professional | None | $87.10 | $104.71 | $213.80 |
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 $64.57 Median $100.00 Typical High $131.83 | Professional | 52 · Reduced service | $64.57 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $39.81 Typical High $52.48 | Professional | 53 · Discontinued | $25.70 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $151.36 Typical High $199.53 | Professional | 54 · Surgery only | $97.72 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $30.20 Typical High $39.81 | Professional | 55 · Aftercare only | $19.50 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.95 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.88 | $19.95 | $26.30 |
Where Massachusetts sits
The same service costs 3.4 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· 12th of 51
$309
AK $525VA $155
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.