How much rates vary
Facilitymedian $58 · 10th to 90th $25 to $2,399Professionalmedian $45 · 10th to 90th $27 to $110
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 $79.43 Median $2,187.76 Typical High $3,630.78 | Facility | None | $79.43 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $29.51 Typical High $74.13 | Professional | None | $27.54 | $29.51 | $74.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $18.20 Median $501.19 Typical High $2,344.23 | Facility | None | $18.20 | $501.19 | $2,344.23 |
AllWays Health Partners Setting Professional Modifier None Typical Low $28.84 Median $57.54 Typical High $794.33 | Professional | None | $28.84 | $57.54 | $794.33 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $56.23 | Facility | None | $24.55 | $24.55 | $56.23 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $24.55 Median $33.11 Typical High $57.54 | Professional | None | $24.55 | $33.11 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $831.76 | Facility | None | $446.68 | $446.68 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $43.65 Typical High $93.33 | Professional | None | $23.99 | $43.65 | $93.33 |
Fallon Health Setting Facility Modifier None Typical Low $26.92 Median $33.11 Typical High $3,311.31 | Facility | None | $26.92 | $33.11 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $57.54 | Professional | None | $35.48 | $42.66 | $57.54 |
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 $29.51 Median $57.54 Typical High $89.13 | Professional | None | $29.51 | $57.54 | $89.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $18.20 Median $501.19 Typical High $2,344.23 | Facility | None | $18.20 | $501.19 | $2,344.23 |
Mass General Brigham Setting Professional Modifier None Typical Low $28.84 Median $57.54 Typical High $794.33 | Professional | None | $28.84 | $57.54 | $794.33 |
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 $30.20 Median $39.81 Typical High $104.71 | Professional | None | $30.20 | $39.81 | $104.71 |
Well Sense Setting Facility Modifier None Typical Low $20.42 Median $28.18 Typical High $47.86 | Facility | None | $20.42 | $28.18 | $47.86 |
Well Sense Setting Professional Modifier None Typical Low $19.50 Median $20.42 Typical High $24.55 | Professional | None | $19.50 | $20.42 | $24.55 |
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 $13.80 Median $14.79 Typical High $37.15 | Professional | 52 · Reduced service | $13.80 | $14.79 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.89 Typical High $14.79 | Professional | 53 · Discontinued | $5.50 | $5.89 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $21.88 Typical High $54.95 | Professional | 54 · Surgery only | $20.42 | $21.88 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.37 Typical High $10.96 | Professional | 55 · Aftercare only | $4.07 | $4.37 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.95 Typical High $7.41 | Professional | 56 · Pre-op care only | $2.75 | $2.95 | $7.41 |
Where Massachusetts sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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
$46.77
AK $110NJ $26.92
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.