How much rates vary
Facilitymedian $87 · 10th to 90th $47 to $282Professionalmedian $62 · 10th to 90th $34 to $490
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 $40.74 Median $40.74 Typical High $186.21 | Facility | None | $40.74 | $40.74 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $186.21 | Professional | None | $40.74 | $40.74 | $186.21 |
AllWays Health Partners Setting Facility Modifier None Typical Low $69.18 Median $89.13 Typical High $288.40 | Facility | None | $69.18 | $89.13 | $288.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $36.31 Median $95.50 Typical High $489.78 | Professional | None | $36.31 | $95.50 | $489.78 |
BCBS Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $162.18 | Facility | None | $53.70 | $53.70 | $162.18 |
BCBS Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | None | $61.66 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $53.70 | Facility | None | $46.77 | $46.77 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $32.36 Median $79.43 Typical High $85.11 | Professional | None | $32.36 | $79.43 | $85.11 |
Health New England Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Health New England Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Mass General Brigham Setting Facility Modifier None Typical Low $69.18 Median $89.13 Typical High $288.40 | Facility | None | $69.18 | $89.13 | $288.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $36.31 Median $95.50 Typical High $489.78 | Professional | None | $36.31 | $95.50 | $489.78 |
United Setting Facility Modifier None Typical Low $19.05 Median $36.31 Typical High $97.72 | Facility | None | $19.05 | $36.31 | $97.72 |
United Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $89.13 | Professional | None | $30.90 | $46.77 | $89.13 |
Well Sense Setting Facility Modifier None Typical Low $72.44 Median $95.50 Typical High $144.54 | Facility | None | $72.44 | $95.50 | $144.54 |
Well Sense Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | None | $53.70 | $53.70 | $64.57 |
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 $20.42 Median $20.42 Typical High $93.33 | Professional | 52 · Reduced service | $20.42 | $20.42 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $37.15 | Professional | 53 · Discontinued | $8.13 | $8.13 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $28.18 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $18.62 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $18.62 |
Where Massachusetts sits
The same service costs 2.9 times more in Kansas than in Delaware. 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· 15th of 51
$67.61
KS $97.72DE $33.88
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.