How much rates vary
Facilitymedian $56 · 10th to 90th $26 to $209Professionalmedian $72 · 10th to 90th $32 to $251
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 $45.71 Median $97.72 Typical High $269.15 | Facility | None | $45.71 | $97.72 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $85.11 Typical High $97.72 | Professional | None | $45.71 | $85.11 | $97.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $141.25 | Facility | None | $91.20 | $120.23 | $141.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $38.02 Median $95.50 Typical High $645.65 | Professional | None | $38.02 | $95.50 | $645.65 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $39.81 Median $169.82 Typical High $239.88 | Facility | None | $39.81 | $169.82 | $239.88 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $169.82 | Professional | None | $42.66 | $70.79 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $60.26 Typical High $128.82 | Professional | None | $31.62 | $60.26 | $128.82 |
Fallon Health Setting Facility Modifier None Typical Low $22.39 Median $43.65 Typical High $69.18 | Facility | None | $22.39 | $43.65 | $69.18 |
Fallon Health Setting Professional Modifier None Typical Low $63.10 Median $114.82 Typical High $169.82 | Professional | None | $63.10 | $114.82 | $169.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $29.51 Median $77.62 Typical High $218.78 | Professional | None | $29.51 | $77.62 | $218.78 |
Health New England Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Mass General Brigham Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $141.25 | Facility | None | $91.20 | $120.23 | $141.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $38.02 Median $95.50 Typical High $645.65 | Professional | None | $38.02 | $95.50 | $645.65 |
United Setting Facility Modifier None Typical Low $186.21 Median $354.81 Typical High $524.81 | Facility | None | $186.21 | $354.81 | $524.81 |
United Setting Professional Modifier None Typical Low $31.62 Median $57.54 Typical High $131.83 | Professional | None | $31.62 | $57.54 | $131.83 |
Well Sense Setting Facility Modifier None Typical Low $37.15 Median $74.13 Typical High $131.83 | Facility | None | $37.15 | $74.13 | $131.83 |
Well Sense Setting Professional Modifier None Typical Low $36.31 Median $69.18 Typical High $83.18 | Professional | None | $36.31 | $69.18 | $83.18 |
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 $22.91 Median $41.69 Typical High $48.98 | Professional | 52 · Reduced service | $22.91 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $16.98 Typical High $19.50 | Professional | 53 · Discontinued | $9.12 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $12.02 Typical High $14.79 | Professional | 55 · Aftercare only | $6.76 | $12.02 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $7.94 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.57 | $7.94 | $9.77 |
BCBS Massachusetts Setting Facility Modifier 52 · Reduced service Typical Low $13.80 Median $15.85 Typical High $20.89 | Facility | 52 · Reduced service | $13.80 | $15.85 | $20.89 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Massachusetts sits
The same service costs 2.5 times more in Alaska than in Washington, DC. 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· 26th of 51
$72.44
AK $129DC $51.29
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.