How much rates vary
Facilitymedian $490 · 10th to 90th $257 to $776Professionalmedian $417 · 10th to 90th $166 to $1,175
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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
AllWays Health Partners Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $891.25 | Facility | None | $660.69 | $776.25 | $891.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $275.42 Median $691.83 Typical High $1,174.90 | Professional | None | $275.42 | $691.83 | $1,174.90 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $446.68 Median $524.81 Typical High $691.83 | Facility | None | $446.68 | $524.81 | $691.83 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $416.87 | Professional | None | $239.88 | $239.88 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $489.78 Typical High $891.25 | Facility | None | $354.81 | $489.78 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Fallon Health Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $281.84 | Facility | None | $269.15 | $269.15 | $281.84 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $275.42 Median $588.84 Typical High $776.25 | Professional | None | $275.42 | $588.84 | $776.25 |
Health New England Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Facility | None | $295.12 | $295.12 | $398.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $891.25 | Facility | None | $660.69 | $776.25 | $891.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $275.42 Median $691.83 Typical High $1,174.90 | Professional | None | $275.42 | $691.83 | $1,174.90 |
Tufts Setting Facility Modifier None Typical Low $398.11 Median $478.63 Typical High $660.69 | Facility | None | $398.11 | $478.63 | $660.69 |
United Setting Facility Modifier None Typical Low $457.09 Median $870.96 Typical High $1,288.25 | Facility | None | $457.09 | $870.96 | $1,288.25 |
United Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $776.25 | Professional | None | $239.88 | $331.13 | $776.25 |
Well Sense Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $380.19 | Facility | None | $223.87 | $269.15 | $380.19 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,388.44 | Professional | None | $2,511.89 | $2,511.89 | $3,388.44 |
4 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 $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where Massachusetts sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 3rd of 51
$417
AK $501CT $158
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.