How much rates vary
Facilitymedian $1,230 · 10th to 90th $661 to $2,291Professionalmedian $661 · 10th to 90th $302 to $1,585
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 $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $741.31 | Professional | None | $524.81 | $524.81 | $741.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $660.69 Median $794.33 Typical High $2,344.23 | Facility | None | $660.69 | $794.33 | $2,344.23 |
AllWays Health Partners Setting Professional Modifier None Typical Low $398.11 Median $794.33 Typical High $5,128.61 | Professional | None | $398.11 | $794.33 | $5,128.61 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $891.25 Median $1,513.56 Typical High $2,089.30 | Facility | None | $891.25 | $1,513.56 | $2,089.30 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $131.83 Median $575.44 Typical High $977.24 | Professional | None | $131.83 | $575.44 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $776.25 | Professional | None | $549.54 | $549.54 | $776.25 |
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 $398.11 Median $676.08 Typical High $933.25 | Professional | None | $398.11 | $676.08 | $933.25 |
Health New England Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Mass General Brigham Setting Facility Modifier None Typical Low $660.69 Median $794.33 Typical High $2,344.23 | Facility | None | $660.69 | $794.33 | $2,344.23 |
Mass General Brigham Setting Professional Modifier None Typical Low $398.11 Median $794.33 Typical High $5,128.61 | Professional | None | $398.11 | $794.33 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Professional Modifier None Typical Low $380.19 Median $602.56 Typical High $870.96 | Professional | None | $380.19 | $602.56 | $870.96 |
Well Sense Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $1,380.38 | Facility | None | $691.83 | $933.25 | $1,380.38 |
Well Sense Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | None | $794.33 | $794.33 | $954.99 |
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 $263.03 Median $263.03 Typical High $346.74 | Professional | 52 · Reduced service | $263.03 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $138.04 | Professional | 53 · Discontinued | $104.71 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $104.71 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $69.18 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $69.18 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii 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· 24th of 51
$676
HI $1,230UT $479
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.