How much rates vary
Facilitymedian $741 · 10th to 90th $251 to $5,248Professionalmedian $776 · 10th to 90th $282 to $3,388
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 $1,318.26 Median $2,570.40 Typical High $6,760.83 | Facility | None | $1,318.26 | $2,570.40 | $6,760.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $776.25 Median $776.25 Typical High $1,737.80 | Professional | None (both parts) | $776.25 | $776.25 | $1,737.80 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $218.78 Median $218.78 Typical High $549.54 | Professional | 26 · Professional part | $218.78 | $218.78 | $549.54 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $562.34 Median $562.34 Typical High $1,174.90 | Professional | TC · Technical part | $562.34 | $562.34 | $1,174.90 |
AllWays Health Partners Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $5,495.41 | Facility | None | $691.83 | $2,187.76 | $5,495.41 |
AllWays Health Partners Setting Professional Modifier None (both parts) Typical Low $478.63 Median $1,819.70 Typical High $5,495.41 | Professional | None (both parts) | $478.63 | $1,819.70 | $5,495.41 |
AllWays Health Partners Setting Professional Modifier 26 · Professional part Typical Low $234.42 Median $575.44 Typical High $1,737.80 | Professional | 26 · Professional part | $234.42 | $575.44 | $1,737.80 |
AllWays Health Partners Setting Professional Modifier TC · Technical part Typical Low $338.84 Median $1,258.93 Typical High $2,884.03 | Professional | TC · Technical part | $338.84 | $1,258.93 | $2,884.03 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $6,309.57 | Facility | None | $4,073.80 | $4,786.30 | $6,309.57 |
BCBS Massachusetts Setting Professional Modifier 26 · Professional part Typical Low $1,778.28 Median $2,454.71 Typical High $2,454.71 | Professional | 26 · Professional part | $1,778.28 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $2,951.21 Typical High $6,760.83 | Facility | None | $50.12 | $2,951.21 | $6,760.83 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,230.27 Typical High $2,041.74 | Professional | None (both parts) | $1,230.27 | $1,230.27 | $2,041.74 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $407.38 Median $407.38 Typical High $645.65 | Professional | 26 · Professional part | $407.38 | $407.38 | $645.65 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $812.83 Median $812.83 Typical High $1,412.54 | Professional | TC · Technical part | $812.83 | $812.83 | $1,412.54 |
Fallon Health Setting Facility Modifier None Typical Low $162.18 Median $436.52 Typical High $1,000.00 | Facility | None | $162.18 | $436.52 | $1,000.00 |
Fallon Health Setting Professional Modifier None (both parts) Typical Low $162.18 Median $426.58 Typical High $933.25 | Professional | None (both parts) | $162.18 | $426.58 | $933.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $660.69 Median $1,513.56 Typical High $2,951.21 | Professional | None (both parts) | $660.69 | $1,513.56 | $2,951.21 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $263.03 Median $478.63 Typical High $724.44 | Professional | 26 · Professional part | $263.03 | $478.63 | $724.44 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $524.81 Median $977.24 Typical High $1,445.44 | Professional | TC · Technical part | $524.81 | $977.24 | $1,445.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $5,495.41 | Facility | None | $691.83 | $2,187.76 | $5,495.41 |
Mass General Brigham Setting Professional Modifier None (both parts) Typical Low $478.63 Median $1,819.70 Typical High $5,495.41 | Professional | None (both parts) | $478.63 | $1,819.70 | $5,495.41 |
Mass General Brigham Setting Professional Modifier 26 · Professional part Typical Low $234.42 Median $575.44 Typical High $1,737.80 | Professional | 26 · Professional part | $234.42 | $575.44 | $1,737.80 |
Mass General Brigham Setting Professional Modifier TC · Technical part Typical Low $338.84 Median $1,258.93 Typical High $2,884.03 | Professional | TC · Technical part | $338.84 | $1,258.93 | $2,884.03 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None (both parts) Typical Low $407.38 Median $1,096.48 Typical High $3,311.31 | Professional | None (both parts) | $407.38 | $1,096.48 | $3,311.31 |
United Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $380.19 Typical High $1,023.29 | Professional | 26 · Professional part | $251.19 | $380.19 | $1,023.29 |
United Setting Professional Modifier TC · Technical part Typical Low $117.49 Median $794.33 Typical High $2,398.83 | Professional | TC · Technical part | $117.49 | $794.33 | $2,398.83 |
Well Sense Setting Facility Modifier None Typical Low $501.19 Median $691.83 Typical High $1,023.29 | Facility | None | $501.19 | $691.83 | $1,023.29 |
Well Sense Setting Facility Modifier 26 · Professional part Typical Low $162.18 Median $208.93 Typical High $380.19 | Facility | 26 · Professional part | $162.18 | $208.93 | $380.19 |
Well Sense Setting Facility Modifier TC · Technical part Typical Low $338.84 Median $446.68 Typical High $794.33 | Facility | TC · Technical part | $338.84 | $446.68 | $794.33 |
Well Sense Setting Professional Modifier None (both parts) Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | None (both parts) | $602.56 | $602.56 | $724.44 |
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 $389.05 Median $389.05 Typical High $1,288.25 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $512.86 | Professional | 53 · Discontinued | $154.88 | $154.88 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $1,905.46 | Professional | 54 · Surgery only | $575.44 | $575.44 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $380.19 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $257.04 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $257.04 |
Where Massachusetts sits
The same service costs 4.4 times more in Wisconsin than in Texas. 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· 41st of 51
$776
WI $2,630TX $603
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.