How much rates vary
Facilitymedian $138 · 10th to 90th $74 to $2,399Professionalmedian $170 · 10th to 90th $85 to $380
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 $194.98 Median $2,187.76 Typical High $3,630.78 | Facility | None | $194.98 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $125.89 | Professional | None | $83.18 | $117.49 | $125.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $56.23 Median $501.19 Typical High $2,344.23 | Facility | None | $56.23 | $501.19 | $2,344.23 |
AllWays Health Partners Setting Professional Modifier None Typical Low $87.10 Median $181.97 Typical High $954.99 | Professional | None | $87.10 | $181.97 | $954.99 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $177.83 | Facility | None | $75.86 | $75.86 | $177.83 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $75.86 Median $151.36 Typical High $338.84 | Professional | None | $75.86 | $151.36 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $758.58 Typical High $1,000.00 | Facility | None | $676.08 | $758.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $295.12 | Professional | None | $109.65 | $169.82 | $295.12 |
Fallon Health Setting Facility Modifier None Typical Low $77.62 Median $97.72 Typical High $3,311.31 | Facility | None | $77.62 | $97.72 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $223.87 | Professional | None | $165.96 | $190.55 | $223.87 |
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 $97.72 Median $186.21 Typical High $371.54 | Professional | None | $97.72 | $186.21 | $371.54 |
Health New England Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Mass General Brigham Setting Facility Modifier None Typical Low $56.23 Median $501.19 Typical High $2,344.23 | Facility | None | $56.23 | $501.19 | $2,344.23 |
Mass General Brigham Setting Professional Modifier None Typical Low $87.10 Median $181.97 Typical High $954.99 | Professional | None | $87.10 | $181.97 | $954.99 |
United Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $2,818.38 | Facility | None | $117.49 | $537.03 | $2,818.38 |
United Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $380.19 | Professional | None | $102.33 | $165.96 | $380.19 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $147.91 | Facility | None | $70.79 | $104.71 | $147.91 |
Well Sense Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $100.00 | Professional | None | $60.26 | $81.28 | $100.00 |
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 $41.69 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $41.69 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $16.60 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $89.13 Typical High $89.13 | Professional | 54 · Surgery only | $63.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $12.59 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.32 | $11.75 | $11.75 |
Where Massachusetts sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$170
AK $331FL $93.33
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.