How much rates vary
Facilitymedian $115 · 10th to 90th $60 to $282Professionalmedian $79 · 10th to 90th $48 to $275
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 $56.23 Median $56.23 Typical High $251.19 | Facility | None | $56.23 | $56.23 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $131.83 | Professional | None | $56.23 | $56.23 | $131.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $60.26 Median $91.20 Typical High $263.03 | Facility | None | $60.26 | $91.20 | $263.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $45.71 Median $81.28 Typical High $295.12 | Professional | None | $45.71 | $81.28 | $295.12 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $25.12 Median $229.09 Typical High $331.13 | Facility | None | $25.12 | $229.09 | $331.13 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $112.20 | Professional | None | $79.43 | $107.15 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $81.28 Typical High $199.53 | Facility | None | $70.79 | $81.28 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $83.18 Typical High $158.49 | Professional | None | $38.02 | $83.18 | $158.49 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $194.98 Typical High $5,888.44 | Facility | None | $83.18 | $194.98 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $45.71 Median $97.72 Typical High $295.12 | Professional | None | $45.71 | $97.72 | $295.12 |
Health New England Setting Facility Modifier None Typical Low $61.66 Median $134.90 Typical High $251.19 | Facility | None | $61.66 | $134.90 | $251.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $60.26 Median $91.20 Typical High $263.03 | Facility | None | $60.26 | $91.20 | $263.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $45.71 Median $81.28 Typical High $295.12 | Professional | None | $45.71 | $81.28 | $295.12 |
Tufts Setting Facility Modifier None Typical Low $60.26 Median $93.33 Typical High $162.18 | Facility | None | $60.26 | $93.33 | $162.18 |
Tufts Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | None | $60.26 | $60.26 | $72.44 |
United Setting Facility Modifier None Typical Low $102.33 Median $114.82 Typical High $138.04 | Facility | None | $102.33 | $114.82 | $138.04 |
United Setting Professional Modifier None Typical Low $40.74 Median $69.18 Typical High $239.88 | Professional | None | $40.74 | $69.18 | $239.88 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $74.13 Typical High $117.49 | Facility | None | $60.26 | $74.13 | $117.49 |
Well Sense Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | None | $60.26 | $60.26 | $72.44 |
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 $28.18 Median $28.18 Typical High $29.51 | Professional | 52 · Reduced service | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.75 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $44.67 | Professional | 54 · Surgery only | $41.69 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.91 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.89 |
Fallon Health Setting Facility Modifier QW · Waived lab test Typical Low $114.82 Median $147.91 Typical High $177.83 | Facility | QW · Waived lab test | $114.82 | $147.91 | $177.83 |
Where Massachusetts sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 27th of 51
$91.20
AK $224GA $45.71
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.