How much rates vary
Facilitymedian $4,898 · 10th to 90th $170 to $14,125Professionalmedian $5,623 · 10th to 90th $3,020 to $6,026
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 $4,073.80 Median $5,888.44 Typical High $12,882.50 | Facility | None | $4,073.80 | $5,888.44 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $169.82 Median $12,022.64 Typical High $15,848.93 | Facility | None | $169.82 | $12,022.64 | $15,848.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,187.76 Median $5,623.41 Typical High $6,025.60 | Professional | None | $2,187.76 | $5,623.41 | $6,025.60 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $4,786.30 Median $5,495.41 Typical High $10,000.00 | Facility | None | $4,786.30 | $5,495.41 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $8,709.64 Typical High $20,892.96 | Facility | None | $4,786.30 | $8,709.64 | $20,892.96 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $8,511.38 | Facility | None | $83.18 | $3,630.78 | $8,511.38 |
Fallon Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4,786.30 Median $5,623.41 Typical High $6,025.60 | Professional | None | $4,786.30 | $5,623.41 | $6,025.60 |
Mass General Brigham Setting Facility Modifier None Typical Low $169.82 Median $12,022.64 Typical High $15,848.93 | Facility | None | $169.82 | $12,022.64 | $15,848.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,187.76 Median $5,623.41 Typical High $6,025.60 | Professional | None | $2,187.76 | $5,623.41 | $6,025.60 |
United Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,025.60 | Professional | None | $5,623.41 | $5,623.41 | $6,025.60 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,467.37 | $5,128.61 |
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 $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $2,041.74 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $407.38 |
Where Massachusetts sits
The same service costs 1.5 times more in Alaska than in Idaho. 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· 7th of 51
$5,623
AK $6,457ID $4,169
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.