How much rates vary
Facilitymedian $60 · 10th to 90th $28 to $417Professionalmedian $145 · 10th to 90th $52 to $562
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 $64.57 Median $295.12 Typical High $380.19 | Facility | None | $64.57 | $295.12 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $144.54 Typical High $144.54 | Professional | None | $52.48 | $144.54 | $144.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $467.74 | Facility | None | $97.72 | $125.89 | $467.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $51.29 Median $181.97 Typical High $851.14 | Professional | None | $51.29 | $181.97 | $851.14 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $41.69 Median $302.00 Typical High $416.87 | Facility | None | $41.69 | $302.00 | $416.87 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $56.23 Median $158.49 Typical High $363.08 | Professional | None | $56.23 | $158.49 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $467.74 Typical High $741.31 | Facility | None | $190.55 | $467.74 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $295.12 | Professional | None | $75.86 | $141.25 | $295.12 |
Fallon Health Setting Facility Modifier None Typical Low $23.99 Median $46.77 Typical High $83.18 | Facility | None | $23.99 | $46.77 | $83.18 |
Fallon Health Setting Professional Modifier None Typical Low $89.13 Median $151.36 Typical High $234.42 | Professional | None | $89.13 | $151.36 | $234.42 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $51.29 Median $144.54 Typical High $371.54 | Professional | None | $51.29 | $144.54 | $371.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $467.74 | Facility | None | $97.72 | $125.89 | $467.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $51.29 Median $181.97 Typical High $851.14 | Professional | None | $51.29 | $181.97 | $851.14 |
United Setting Facility Modifier None Typical Low $295.12 Median $562.34 Typical High $831.76 | Facility | None | $295.12 | $562.34 | $831.76 |
United Setting Professional Modifier None Typical Low $51.29 Median $141.25 Typical High $380.19 | Professional | None | $51.29 | $141.25 | $380.19 |
Well Sense Setting Facility Modifier None Typical Low $38.90 Median $77.62 Typical High $165.96 | Facility | None | $38.90 | $77.62 | $165.96 |
Well Sense Setting Professional Modifier None Typical Low $32.36 Median $47.86 Typical High $112.20 | Professional | None | $32.36 | $47.86 | $112.20 |
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 $26.30 Median $70.79 Typical High $72.44 | Professional | 52 · Reduced service | $26.30 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $10.72 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $7.94 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $5.25 | $14.45 | $14.45 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $20.42 Median $30.90 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $20.42 | $30.90 | $74.13 |
Where Massachusetts sits
The same service costs 3.5 times more in Wisconsin 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· 10th of 51
$145
WI $182DC $52.48
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.