How much rates vary
Facilitymedian $102 · 10th to 90th $63 to $170Professionalmedian $63 · 10th to 90th $41 to $813
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 $87.10 Median $95.50 Typical High $288.40 | Facility | None | $87.10 | $95.50 | $288.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $40.74 Median $93.33 Typical High $812.83 | Professional | None | $40.74 | $93.33 | $812.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $93.33 Median $120.23 Typical High $162.18 | Facility | None | $93.33 | $120.23 | $162.18 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | None | $60.26 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $63.10 Typical High $64.57 | Facility | None | $53.70 | $63.10 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
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 $36.31 Median $77.62 Typical High $83.18 | Professional | None | $36.31 | $77.62 | $83.18 |
Health New England Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Health New England Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Mass General Brigham Setting Facility Modifier None Typical Low $87.10 Median $95.50 Typical High $288.40 | Facility | None | $87.10 | $95.50 | $288.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $40.74 Median $93.33 Typical High $812.83 | Professional | None | $40.74 | $93.33 | $812.83 |
United Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $125.89 | Facility | None | $61.66 | $63.10 | $125.89 |
United Setting Professional Modifier None Typical Low $30.90 Median $45.71 Typical High $89.13 | Professional | None | $30.90 | $45.71 | $89.13 |
Well Sense Setting Facility Modifier None Typical Low $83.18 Median $109.65 Typical High $162.18 | Facility | None | $83.18 | $109.65 | $162.18 |
Well Sense Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | None | $60.26 | $60.26 | $72.44 |
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 $19.95 Median $19.95 Typical High $91.20 | Professional | 52 · Reduced service | $19.95 | $19.95 | $91.20 |
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 $6.03 Median $6.03 Typical High $27.54 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $27.54 |
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 4.3 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· 18th of 51
$72.44
HI $195DE $45.71
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.