How much rates vary
Facilitymedian $174 · 10th to 90th $100 to $537Professionalmedian $117 · 10th to 90th $76 to $1,023
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 $75.86 Median $75.86 Typical High $346.74 | Facility | None | $75.86 | $75.86 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $346.74 | Professional | None | $75.86 | $75.86 | $346.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $165.96 Median $173.78 Typical High $549.54 | Facility | None | $165.96 | $173.78 | $549.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $75.86 Median $177.83 Typical High $1,023.29 | Professional | None | $75.86 | $177.83 | $1,023.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $309.03 | Facility | None | $100.00 | $100.00 | $309.03 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | None | $114.82 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $123.03 | Facility | None | $100.00 | $120.23 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $123.03 | Professional | None | $87.10 | $87.10 | $123.03 |
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 $67.61 Median $147.91 Typical High $158.49 | Professional | None | $67.61 | $147.91 | $158.49 |
Health New England Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Mass General Brigham Setting Facility Modifier None Typical Low $165.96 Median $173.78 Typical High $549.54 | Facility | None | $165.96 | $173.78 | $549.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $75.86 Median $177.83 Typical High $1,023.29 | Professional | None | $75.86 | $177.83 | $1,023.29 |
United Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $229.09 | Facility | None | $72.44 | $85.11 | $229.09 |
United Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $169.82 | Professional | None | $57.54 | $87.10 | $169.82 |
Well Sense Setting Facility Modifier None Typical Low $154.88 Median $208.93 Typical High $309.03 | Facility | None | $154.88 | $208.93 | $309.03 |
Well Sense Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $134.90 | Professional | None | $114.82 | $114.82 | $134.90 |
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 $38.02 Median $38.02 Typical High $173.78 | Professional | 52 · Reduced service | $38.02 | $38.02 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $69.18 | Professional | 53 · Discontinued | $15.14 | $15.14 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $52.48 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $34.67 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $34.67 |
Where Massachusetts sits
The same service costs 2.4 times more in Montana than in Vermont. 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· 17th of 51
$123
MT $209VT $87.10
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.