How much rates vary
Facilitymedian $355 · 10th to 90th $145 to $2,344Professionalmedian $479 · 10th to 90th $200 to $1,514
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $446.68 | Professional | None | $190.55 | $251.19 | $446.68 |
AllWays Health Partners Setting Facility Modifier None Typical Low $128.82 Median $389.05 Typical High $1,862.09 | Facility | None | $128.82 | $389.05 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $245.47 Median $660.69 Typical High $2,511.89 | Professional | None | $245.47 | $660.69 | $2,511.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $407.38 | Facility | None | $173.78 | $173.78 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $758.58 Typical High $1,000.00 | Facility | None | $676.08 | $758.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $489.78 | Professional | None | $288.40 | $288.40 | $489.78 |
Fallon Health Setting Facility Modifier None Typical Low $158.49 Median $218.78 Typical High $3,311.31 | Facility | None | $158.49 | $218.78 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $562.34 | Professional | None | $389.05 | $457.09 | $562.34 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $208.93 Median $457.09 Typical High $933.25 | Professional | None | $208.93 | $457.09 | $933.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $128.82 Median $389.05 Typical High $1,862.09 | Facility | None | $128.82 | $389.05 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $245.47 Median $660.69 Typical High $2,511.89 | Professional | None | $245.47 | $660.69 | $2,511.89 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $245.47 Median $575.44 Typical High $1,174.90 | Professional | None | $245.47 | $575.44 | $1,174.90 |
Well Sense Setting Facility Modifier None Typical Low $186.21 Median $354.81 Typical High $575.44 | Facility | None | $186.21 | $354.81 | $575.44 |
Well Sense Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $426.58 | Professional | None | $154.88 | $186.21 | $426.58 |
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 $95.50 Median $125.89 Typical High $223.87 | Professional | 52 · Reduced service | $95.50 | $125.89 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $51.29 Typical High $89.13 | Professional | 53 · Discontinued | $38.02 | $51.29 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $190.55 Typical High $331.13 | Professional | 54 · Surgery only | $141.25 | $190.55 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $38.02 Typical High $66.07 | Professional | 55 · Aftercare only | $28.18 | $38.02 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $25.12 Typical High $44.67 | Professional | 56 · Pre-op care only | $19.05 | $25.12 | $44.67 |
Where Massachusetts sits
The same service costs 2.8 times more in Wisconsin than in Utah. 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
$447
WI $813UT $288
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.