How much rates vary
Facilitymedian $100 · 10th to 90th $47 to $2,239Professionalmedian $112 · 10th to 90th $50 to $363
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 $109.65 Median $2,691.53 Typical High $5,128.61 | Facility | None | $109.65 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $104.71 Typical High $158.49 | Professional | None | $50.12 | $104.71 | $158.49 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $234.42 Typical High $1,862.09 | Facility | None | $50.12 | $234.42 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $53.70 Median $138.04 Typical High $676.08 | Professional | None | $53.70 | $138.04 | $676.08 |
BCBS Setting Facility Modifier None Typical Low $46.77 Median $56.23 Typical High $107.15 | Facility | None | $46.77 | $56.23 | $107.15 |
BCBS Setting Professional Modifier None Typical Low $46.77 Median $95.50 Typical High $165.96 | Professional | None | $46.77 | $95.50 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $100.00 | Facility | None | $50.12 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $104.71 Typical High $218.78 | Professional | None | $60.26 | $104.71 | $218.78 |
Fallon Health Setting Facility Modifier None Typical Low $46.77 Median $61.66 Typical High $3,311.31 | Facility | None | $46.77 | $61.66 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $147.91 | Professional | None | $100.00 | $120.23 | $147.91 |
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 $50.12 Median $114.82 Typical High $234.42 | Professional | None | $50.12 | $114.82 | $234.42 |
Health New England Setting Facility Modifier None Typical Low $117.49 Median $162.18 Typical High $338.84 | Facility | None | $117.49 | $162.18 | $338.84 |
Health New England Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $147.91 | Professional | None | $104.71 | $104.71 | $147.91 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $234.42 Typical High $1,862.09 | Facility | None | $50.12 | $234.42 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $53.70 Median $138.04 Typical High $676.08 | Professional | None | $53.70 | $138.04 | $676.08 |
United Setting Facility Modifier None Typical Low $123.03 Median $524.81 Typical High $2,754.23 | Facility | None | $123.03 | $524.81 | $2,754.23 |
United Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $239.88 | Professional | None | $58.88 | $117.49 | $239.88 |
Well Sense Setting Facility Modifier None Typical Low $35.48 Median $61.66 Typical High $104.71 | Facility | None | $35.48 | $61.66 | $104.71 |
Well Sense Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $109.65 | Professional | None | $40.74 | $48.98 | $109.65 |
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 $25.12 Median $54.95 Typical High $79.43 | Professional | 52 · Reduced service | $25.12 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $21.88 Typical High $31.62 | Professional | 53 · Discontinued | $10.00 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $83.18 Typical High $120.23 | Professional | 54 · Surgery only | $37.15 | $83.18 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $16.60 Typical High $23.99 | Professional | 55 · Aftercare only | $7.41 | $16.60 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $10.96 Typical High $15.85 | Professional | 56 · Pre-op care only | $5.01 | $10.96 | $15.85 |
BCBS Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $67.61 Typical High $120.23 | Professional | 52 · Reduced service | $38.02 | $67.61 | $120.23 |
Where Massachusetts sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 13th of 51
$112
AK $214KY $64.57
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.