How much rates vary
Facilitymedian $47 · 10th to 90th $22 to $302Professionalmedian $42 · 10th to 90th $30 to $89
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 $36.31 Median $64.57 Typical High $190.55 | Facility | None | $36.31 | $64.57 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $46.77 | Professional | None | $36.31 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $21.38 Typical High $21.88 | Professional | 52 · Reduced service | $18.20 | $21.38 | $21.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $77.62 Median $100.00 Typical High $331.13 | Facility | None | $77.62 | $100.00 | $331.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $31.62 Median $44.67 Typical High $288.40 | Professional | None | $31.62 | $44.67 | $288.40 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $33.11 Median $208.93 Typical High $302.00 | Facility | None | $33.11 | $208.93 | $302.00 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $33.11 Median $50.12 Typical High $50.12 | Professional | None | $33.11 | $50.12 | $50.12 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $25.12 | $25.12 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $281.84 Typical High $457.09 | Facility | None | $120.23 | $281.84 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $69.18 | Professional | None | $30.20 | $38.90 | $69.18 |
Fallon Health Setting Facility Modifier None Typical Low $19.05 Median $36.31 Typical High $50.12 | Facility | None | $19.05 | $36.31 | $50.12 |
Fallon Health Setting Professional Modifier None Typical Low $27.54 Median $48.98 Typical High $70.79 | Professional | None | $27.54 | $48.98 | $70.79 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $24.55 Median $36.31 Typical High $63.10 | Professional | None | $24.55 | $36.31 | $63.10 |
Health New England Setting Facility Modifier None Typical Low $169.82 Median $223.87 Typical High $239.88 | Facility | None | $169.82 | $223.87 | $239.88 |
Health New England Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $83.18 | Professional | None | $66.07 | $66.07 | $83.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $77.62 Median $100.00 Typical High $331.13 | Facility | None | $77.62 | $100.00 | $331.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $31.62 Median $44.67 Typical High $288.40 | Professional | None | $31.62 | $44.67 | $288.40 |
Tufts Setting Facility Modifier None Typical Low $27.54 Median $257.04 Typical High $436.52 | Facility | None | $27.54 | $257.04 | $436.52 |
United Setting Facility Modifier None Typical Low $302.00 Median $575.44 Typical High $851.14 | Facility | None | $302.00 | $575.44 | $851.14 |
United Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $70.79 | Professional | None | $30.90 | $41.69 | $70.79 |
Well Sense Setting Facility Modifier None Typical Low $32.36 Median $42.66 Typical High $64.57 | Facility | None | $32.36 | $42.66 | $64.57 |
Well Sense Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $39.81 | Professional | None | $30.20 | $33.11 | $39.81 |
3 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 53 · Discontinued Typical Low $7.24 Median $8.51 Typical High $8.71 | Professional | 53 · Discontinued | $7.24 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.46 Typical High $6.61 | Professional | 55 · Aftercare only | $5.50 | $6.46 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.27 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.63 | $4.27 | $4.37 |
Where Massachusetts sits
The same service costs 2.9 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· 36th of 51
$41.69
AK $100KY $34.67
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.