How much rates vary
Facilitymedian $214 · 10th to 90th $60 to $417Professionalmedian $141 · 10th to 90th $79 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 $89.13 Median $89.13 Typical High $407.38 | Facility | None | $89.13 | $89.13 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $407.38 | Professional | None | $89.13 | $89.13 | $407.38 |
AllWays Health Partners Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $645.65 | Facility | None | $190.55 | $194.98 | $645.65 |
AllWays Health Partners Setting Professional Modifier None Typical Low $85.11 Median $208.93 Typical High $1,071.52 | Professional | None | $85.11 | $208.93 | $1,071.52 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $263.03 Median $309.03 Typical High $407.38 | Facility | None | $263.03 | $309.03 | $407.38 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | None | $134.90 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
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 $79.43 Median $173.78 Typical High $186.21 | Professional | None | $79.43 | $173.78 | $186.21 |
Health New England Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $79.43 | Facility | None | $60.26 | $60.26 | $79.43 |
Health New England Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $645.65 | Facility | None | $190.55 | $194.98 | $645.65 |
Mass General Brigham Setting Professional Modifier None Typical Low $85.11 Median $208.93 Typical High $1,071.52 | Professional | None | $85.11 | $208.93 | $1,071.52 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $199.53 | Professional | None | $67.61 | $102.33 | $199.53 |
Well Sense Setting Facility Modifier None Typical Low $181.97 Median $245.47 Typical High $363.08 | Facility | None | $181.97 | $245.47 | $363.08 |
Well Sense Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | None | $134.90 | $134.90 | $158.49 |
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 $44.67 Median $44.67 Typical High $204.17 | Professional | 52 · Reduced service | $44.67 | $44.67 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $81.28 | Professional | 53 · Discontinued | $17.78 | $17.78 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $61.66 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $40.74 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $40.74 |
Where Massachusetts sits
The same service costs 2.0 times more in Wyoming 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
$158
WY $209NJ $102
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.