How much rates vary
Facilitymedian $200 · 10th to 90th $112 to $3,388Professionalmedian $288 · 10th to 90th $115 to $1,096
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 $125.89 Median $218.78 Typical High $275.42 | Professional | None | $125.89 | $218.78 | $275.42 |
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 $128.82 Median $354.81 Typical High $1,819.70 | Professional | None | $128.82 | $354.81 | $1,819.70 |
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 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $112.20 Median $288.40 Typical High $288.40 | Professional | None | $112.20 | $288.40 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $309.03 Typical High $602.56 | Professional | None | $158.49 | $309.03 | $602.56 |
Fallon Health Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $3,311.31 | Facility | None | $112.20 | $138.04 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $501.19 | Professional | None | $295.12 | $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 $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
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 $128.82 Median $354.81 Typical High $1,819.70 | Professional | None | $128.82 | $354.81 | $1,819.70 |
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 $758.58 | Professional | None | $147.91 | $323.59 | $758.58 |
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 $85.11 Median $102.33 Typical High $208.93 | Professional | None | $85.11 | $102.33 | $208.93 |
6 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 $63.10 Median $97.72 Typical High $128.82 | Professional | 52 · Reduced service | $63.10 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $38.90 Typical High $52.48 | Professional | 53 · Discontinued | $25.12 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $147.91 Typical High $194.98 | Professional | 54 · Surgery only | $95.50 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $29.51 Typical High $38.90 | Professional | 55 · Aftercare only | $19.05 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.50 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.59 | $19.50 | $26.30 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $30.90 Typical High $63.10 | Professional | 53 · Discontinued | $27.54 | $30.90 | $63.10 |
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· 15th of 51
$288
AK $513VA $151
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.