How much rates vary
Facilitymedian $129 · 10th to 90th $19 to $2,692Professionalmedian $27 · 10th to 90th $12 to $79
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 $30.90 Median $2,137.96 Typical High $3,630.78 | Facility | None | $30.90 | $2,137.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $33.11 | Professional | None | $11.75 | $11.75 | $33.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $45.71 Median $134.90 Typical High $1,862.09 | Facility | None | $45.71 | $134.90 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $15.14 Median $42.66 Typical High $125.89 | Professional | None | $15.14 | $42.66 | $125.89 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $20.89 Median $27.54 Typical High $45.71 | Professional | None | $20.89 | $27.54 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $741.31 Typical High $954.99 | Facility | None | $107.15 | $741.31 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $48.98 | Professional | None | $21.38 | $21.38 | $48.98 |
Fallon Health Setting Facility Modifier None Typical Low $20.42 Median $26.30 Typical High $3,311.31 | Facility | None | $20.42 | $26.30 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $21.38 Median $25.70 Typical High $31.62 | Professional | None | $21.38 | $25.70 | $31.62 |
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 $18.20 Median $38.02 Typical High $56.23 | Professional | None | $18.20 | $38.02 | $56.23 |
Health New England Setting Facility Modifier None Typical Low $128.82 Median $162.18 Typical High $398.11 | Facility | None | $128.82 | $162.18 | $398.11 |
Health New England Setting Professional Modifier None Typical Low $29.51 Median $40.74 Typical High $44.67 | Professional | None | $29.51 | $40.74 | $44.67 |
Mass General Brigham Setting Facility Modifier None Typical Low $45.71 Median $134.90 Typical High $1,862.09 | Facility | None | $45.71 | $134.90 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $15.14 Median $42.66 Typical High $125.89 | Professional | None | $15.14 | $42.66 | $125.89 |
Tufts Setting Professional Modifier None Typical Low $8.32 Median $15.14 Typical High $32.36 | Professional | None | $8.32 | $15.14 | $32.36 |
United Setting Facility Modifier None Typical Low $87.10 Median $524.81 Typical High $2,754.23 | Facility | None | $87.10 | $524.81 | $2,754.23 |
United Setting Professional Modifier None Typical Low $16.98 Median $25.12 Typical High $52.48 | Professional | None | $16.98 | $25.12 | $52.48 |
Well Sense Setting Facility Modifier None Typical Low $12.30 Median $16.60 Typical High $25.12 | Facility | None | $12.30 | $16.60 | $25.12 |
Well Sense Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.23 | Professional | None | $8.51 | $8.51 | $10.23 |
7 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 $5.89 Median $5.89 Typical High $6.76 | Professional | 52 · Reduced service | $5.89 | $5.89 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $2.69 | Professional | 53 · Discontinued | $2.34 | $2.34 | $2.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $8.71 Typical High $10.00 | Professional | 54 · Surgery only | $8.71 | $8.71 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $2.00 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $1.35 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $17.38 Typical High $23.99 | Professional | 52 · Reduced service | $10.47 | $17.38 | $23.99 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $8.71 Typical High $12.02 | Professional | 53 · Discontinued | $5.25 | $8.71 | $12.02 |
Where Massachusetts sits
The same service costs 7.4 times more in Kansas 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· 16th of 51
$30.20
KS $95.50KY $12.88
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.