How much rates vary
Facilitymedian $105 · 10th to 90th $51 to $204Professionalmedian $68 · 10th to 90th $43 to $209
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 $45.71 Median $45.71 Typical High $208.93 | Facility | None | $45.71 | $45.71 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $165.96 | Professional | None | $45.71 | $45.71 | $165.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $93.33 Median $97.72 Typical High $323.59 | Facility | None | $93.33 | $97.72 | $323.59 |
AllWays Health Partners Setting Professional Modifier None Typical Low $40.74 Median $104.71 Typical High $602.56 | Professional | None | $40.74 | $104.71 | $602.56 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $104.71 Median $134.90 Typical High $181.97 | Facility | None | $104.71 | $134.90 | $181.97 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $60.26 Median $67.61 Typical High $114.82 | Professional | None | $60.26 | $67.61 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $64.57 | Facility | None | $57.54 | $57.54 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $58.88 | Professional | None | $42.66 | $42.66 | $58.88 |
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 $40.74 Median $87.10 Typical High $93.33 | Professional | None | $40.74 | $87.10 | $93.33 |
Health New England Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Health New England Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $56.23 | Professional | None | $51.29 | $51.29 | $56.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $93.33 Median $97.72 Typical High $323.59 | Facility | None | $93.33 | $97.72 | $323.59 |
Mass General Brigham Setting Professional Modifier None Typical Low $40.74 Median $104.71 Typical High $602.56 | Professional | None | $40.74 | $104.71 | $602.56 |
Tufts Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $81.28 | Professional | None | $70.79 | $70.79 | $81.28 |
United Setting Facility Modifier None Typical Low $43.65 Median $51.29 Typical High $123.03 | Facility | None | $43.65 | $51.29 | $123.03 |
United Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $102.33 | Professional | None | $34.67 | $51.29 | $102.33 |
Well Sense Setting Facility Modifier None Typical Low $81.28 Median $107.15 Typical High $158.49 | Facility | None | $81.28 | $107.15 | $158.49 |
Well Sense Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $75.86 | Professional | None | $64.57 | $64.57 | $75.86 |
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 $22.39 Median $22.39 Typical High $102.33 | Professional | 52 · Reduced service | $22.39 | $22.39 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $41.69 | Professional | 53 · Discontinued | $9.12 | $9.12 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $30.90 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $20.89 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $20.89 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii 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· 24th of 51
$67.61
HI $117DE $44.67
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.