How much rates vary
Facilitymedian $115 · 10th to 90th $49 to $2,042Professionalmedian $120 · 10th to 90th $56 to $447
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 $123.03 Median $2,691.53 Typical High $5,128.61 | Facility | None | $123.03 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $109.65 Typical High $177.83 | Professional | None | $53.70 | $109.65 | $177.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $295.12 Typical High $1,862.09 | Facility | None | $50.12 | $295.12 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $60.26 Median $138.04 Typical High $676.08 | Professional | None | $60.26 | $138.04 | $676.08 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $114.82 | Facility | None | $48.98 | $48.98 | $114.82 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $41.69 Median $85.11 Typical High $234.42 | Professional | None | $41.69 | $85.11 | $234.42 |
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 $66.07 Median $102.33 Typical High $234.42 | Professional | None | $66.07 | $102.33 | $234.42 |
Fallon Health Setting Facility Modifier None Typical Low $48.98 Median $64.57 Typical High $3,311.31 | Facility | None | $48.98 | $64.57 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $141.25 | Professional | None | $95.50 | $114.82 | $141.25 |
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 $56.23 Median $117.49 Typical High $223.87 | Professional | None | $56.23 | $117.49 | $223.87 |
Health New England Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $295.12 Typical High $1,862.09 | Facility | None | $50.12 | $295.12 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $60.26 Median $138.04 Typical High $676.08 | Professional | None | $60.26 | $138.04 | $676.08 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $66.07 Median $117.49 Typical High $234.42 | Professional | None | $66.07 | $117.49 | $234.42 |
Well Sense Setting Facility Modifier None Typical Low $38.02 Median $66.07 Typical High $102.33 | Facility | None | $38.02 | $66.07 | $102.33 |
Well Sense Setting Professional Modifier None Typical Low $45.71 Median $54.95 Typical High $123.03 | Professional | None | $45.71 | $54.95 | $123.03 |
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 $26.92 Median $61.66 Typical High $89.13 | Professional | 52 · Reduced service | $26.92 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $24.55 Typical High $35.48 | Professional | 53 · Discontinued | $10.72 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $93.33 Typical High $134.90 | Professional | 54 · Surgery only | $39.81 | $93.33 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $18.62 Typical High $26.92 | Professional | 55 · Aftercare only | $7.94 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $12.30 Typical High $17.78 | Professional | 56 · Pre-op care only | $5.37 | $12.30 | $17.78 |
Where Massachusetts sits
The same service costs 3.2 times more in Wisconsin 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
$120
WI $229KY $72.44
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.