How much rates vary
Facilitymedian $132 · 10th to 90th $72 to $257Professionalmedian $85 · 10th to 90th $49 to $1,072
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 $56.23 Median $56.23 Typical High $257.04 | Facility | None | $56.23 | $56.23 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $257.04 | Professional | None | $56.23 | $56.23 | $257.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $109.65 Median $123.03 Typical High $407.38 | Facility | None | $109.65 | $123.03 | $407.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $48.98 Median $131.83 Typical High $1,071.52 | Professional | None | $48.98 | $131.83 | $1,071.52 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $131.83 Median $169.82 Typical High $223.87 | Facility | None | $131.83 | $169.82 | $223.87 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $107.15 | Professional | None | $85.11 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $79.43 | Facility | None | $72.44 | $72.44 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
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 $43.65 Median $109.65 Typical High $117.49 | Professional | None | $43.65 | $109.65 | $117.49 |
Health New England Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Health New England Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $109.65 Median $123.03 Typical High $407.38 | Facility | None | $109.65 | $123.03 | $407.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $48.98 Median $131.83 Typical High $1,071.52 | Professional | None | $48.98 | $131.83 | $1,071.52 |
Tufts Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $117.49 | Professional | None | $93.33 | $117.49 | $117.49 |
United Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $131.83 | Facility | None | $64.57 | $100.00 | $131.83 |
United Setting Professional Modifier None Typical Low $43.65 Median $64.57 Typical High $125.89 | Professional | None | $43.65 | $64.57 | $125.89 |
Well Sense Setting Facility Modifier None Typical Low $117.49 Median $158.49 Typical High $229.09 | Facility | None | $117.49 | $158.49 | $229.09 |
Well Sense Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | None | $85.11 | $85.11 | $102.33 |
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 $28.18 Median $28.18 Typical High $128.82 | Professional | 52 · Reduced service | $28.18 | $28.18 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $52.48 | Professional | 53 · Discontinued | $11.22 | $11.22 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $38.90 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $25.70 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $25.70 |
Where Massachusetts sits
The same service costs 5.0 times more in Hawaii than in Florida. 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· 7th of 51
$100
HI $257FL $51.29
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.