How much rates vary
Facilitymedian $186 · 10th to 90th $138 to $398Professionalmedian $145 · 10th to 90th $138 to $617
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 $144.54 Median $144.54 Typical High $199.53 | Facility | None | $144.54 | $144.54 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | None | $144.54 | $144.54 | $147.91 |
AllWays Health Partners Setting Facility Modifier None Typical Low $117.49 Median $158.49 Typical High $467.74 | Facility | None | $117.49 | $158.49 | $467.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $616.60 | Professional | None | $138.04 | $144.54 | $616.60 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $144.54 Median $162.18 Typical High $295.12 | Facility | None | $144.54 | $162.18 | $295.12 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $288.40 | Professional | None | $144.54 | $190.55 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $257.04 Typical High $616.60 | Facility | None | $138.04 | $257.04 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Fallon Health Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $208.93 | Facility | None | $138.04 | $186.21 | $208.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $165.96 | Professional | None | $138.04 | $144.54 | $165.96 |
Health New England Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $117.49 Median $158.49 Typical High $467.74 | Facility | None | $117.49 | $158.49 | $467.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $616.60 | Professional | None | $138.04 | $144.54 | $616.60 |
Tufts Setting Facility Modifier None Typical Low $138.04 Median $204.17 Typical High $295.12 | Facility | None | $138.04 | $204.17 | $295.12 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | None | $138.04 | $138.04 | $144.54 |
Well Sense Setting Facility Modifier None Typical Low $151.36 Median $208.93 Typical High $331.13 | Facility | None | $151.36 | $208.93 | $331.13 |
Well Sense Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $194.98 | Professional | None | $144.54 | $144.54 | $194.98 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
Where Massachusetts sits
Rates are fairly even across states for this service. 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· 50th of 51
$145
AK $178TN $145
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.