How much rates vary
Facilitymedian $87 · 10th to 90th $35 to $427Professionalmedian $178 · 10th to 90th $72 to $501
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 $489.78 Median $2,187.76 Typical High $3,630.78 | Facility | None | $489.78 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $173.78 Typical High $223.87 | Professional | None | $72.44 | $173.78 | $223.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $38.90 Median $128.82 Typical High $354.81 | Facility | None | $38.90 | $128.82 | $354.81 |
AllWays Health Partners Setting Professional Modifier None Typical Low $75.86 Median $229.09 Typical High $1,230.27 | Professional | None | $75.86 | $229.09 | $1,230.27 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $52.48 Median $281.84 Typical High $398.11 | Facility | None | $52.48 | $281.84 | $398.11 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $52.48 Median $169.82 Typical High $309.03 | Professional | None | $52.48 | $169.82 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $354.81 Typical High $549.54 | Facility | None | $147.91 | $354.81 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $177.83 Typical High $380.19 | Professional | None | $64.57 | $177.83 | $380.19 |
Fallon Health Setting Facility Modifier None Typical Low $30.20 Median $58.88 Typical High $83.18 | Facility | None | $30.20 | $58.88 | $83.18 |
Fallon Health Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $245.47 | Professional | None | $97.72 | $169.82 | $245.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $75.86 Median $177.83 Typical High $426.58 | Professional | None | $75.86 | $177.83 | $426.58 |
Mass General Brigham Setting Facility Modifier None Typical Low $38.90 Median $128.82 Typical High $354.81 | Facility | None | $38.90 | $128.82 | $354.81 |
Mass General Brigham Setting Professional Modifier None Typical Low $75.86 Median $229.09 Typical High $1,230.27 | Professional | None | $75.86 | $229.09 | $1,230.27 |
United Setting Facility Modifier None Typical Low $281.84 Median $524.81 Typical High $794.33 | Facility | None | $281.84 | $524.81 | $794.33 |
United Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $501.19 | Professional | None | $79.43 | $199.53 | $501.19 |
Well Sense Setting Facility Modifier None Typical Low $63.10 Median $123.03 Typical High $218.78 | Facility | None | $63.10 | $123.03 | $218.78 |
Well Sense Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $154.88 | Professional | None | $48.98 | $58.88 | $154.88 |
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 $36.31 Median $87.10 Typical High $91.20 | Professional | 52 · Reduced service | $36.31 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $34.67 Typical High $36.31 | Professional | 53 · Discontinued | $14.45 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $131.83 Typical High $134.90 | Professional | 54 · Surgery only | $54.95 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $26.30 Typical High $26.92 | Professional | 55 · Aftercare only | $10.96 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $17.38 Typical High $18.20 | Professional | 56 · Pre-op care only | $7.24 | $17.38 | $18.20 |
Where Massachusetts sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 14th of 51
$178
AK $288MD $83.18
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.