How much rates vary
Facilitymedian $224 · 10th to 90th $162 to $537Professionalmedian $178 · 10th to 90th $162 to $263
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 $162.18 Median $251.19 Typical High $575.44 | Facility | None | $162.18 | $251.19 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $371.54 | Professional | None | $162.18 | $162.18 | $371.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $165.96 Median $467.74 Typical High $1,288.25 | Facility | None | $165.96 | $467.74 | $1,288.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $199.53 | Professional | None | $162.18 | $177.83 | $199.53 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $162.18 Median $181.97 Typical High $331.13 | Facility | None | $162.18 | $181.97 | $331.13 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $281.84 | Professional | None | $162.18 | $162.18 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $288.40 Typical High $691.83 | Facility | None | $169.82 | $288.40 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Fallon Health Setting Facility Modifier None Typical Low $162.18 Median $223.87 Typical High $251.19 | Facility | None | $162.18 | $223.87 | $251.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $186.21 | Professional | None | $162.18 | $177.83 | $186.21 |
Health New England Setting Facility Modifier None Typical Low $295.12 Median $758.58 Typical High $1,174.90 | Facility | None | $295.12 | $758.58 | $1,174.90 |
Health New England Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $165.96 Median $467.74 Typical High $1,288.25 | Facility | None | $165.96 | $467.74 | $1,288.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $199.53 | Professional | None | $162.18 | $177.83 | $199.53 |
Tufts Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $457.09 | Facility | None | $165.96 | $223.87 | $457.09 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | None | $177.83 | $177.83 | $199.53 |
Well Sense Setting Facility Modifier None Typical Low $194.98 Median $239.88 Typical High $371.54 | Facility | None | $194.98 | $239.88 | $371.54 |
Well Sense Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $218.78 | Professional | None | $162.18 | $162.18 | $218.78 |
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 $83.18 | Professional | 52 · Reduced service | $79.43 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $33.11 | Professional | 53 · Discontinued | $32.36 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $25.12 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $16.60 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $16.60 |
Where Massachusetts sits
The same service costs 1.9 times more in Wyoming than in Nevada. 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· 12th of 51
$178
WY $302NV $162
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.