How much rates vary
Facilitymedian $162 · 10th to 90th $93 to $295Professionalmedian $102 · 10th to 90th $65 to $933
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 $64.57 Median $64.57 Typical High $295.12 | Facility | None | $64.57 | $64.57 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $295.12 | Professional | None | $64.57 | $64.57 | $295.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $138.04 Median $144.54 Typical High $467.74 | Facility | None | $138.04 | $144.54 | $467.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $64.57 Median $151.36 Typical High $933.25 | Professional | None | $64.57 | $151.36 | $933.25 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $257.04 | Facility | None | $151.36 | $190.55 | $257.04 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | None | $97.72 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $102.33 Typical High $104.71 | Facility | None | $85.11 | $102.33 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $104.71 | Professional | None | $74.13 | $74.13 | $104.71 |
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 $57.54 Median $125.89 Typical High $134.90 | Professional | None | $57.54 | $125.89 | $134.90 |
Health New England Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Health New England Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $138.04 Median $144.54 Typical High $467.74 | Facility | None | $138.04 | $144.54 | $467.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $64.57 Median $151.36 Typical High $933.25 | Professional | None | $64.57 | $151.36 | $933.25 |
Tufts Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $134.90 | Professional | None | $107.15 | $131.83 | $134.90 |
United Setting Facility Modifier None Typical Low $87.10 Median $190.55 Typical High $190.55 | Facility | None | $87.10 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $144.54 | Professional | None | $48.98 | $74.13 | $144.54 |
Well Sense Setting Facility Modifier None Typical Low $131.83 Median $177.83 Typical High $263.03 | Facility | None | $131.83 | $177.83 | $263.03 |
Well Sense Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $114.82 | Professional | None | $97.72 | $97.72 | $114.82 |
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 $32.36 Median $32.36 Typical High $147.91 | Professional | 52 · Reduced service | $32.36 | $32.36 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $58.88 | Professional | 53 · Discontinued | $12.88 | $12.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $44.67 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $29.51 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $29.51 |
Where Massachusetts sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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
$115
HI $214NJ $74.13
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.