How much rates vary
Facilitymedian $62 · 10th to 90th $32 to $170Professionalmedian $35 · 10th to 90th $23 to $288
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 $23.99 Median $23.99 Typical High $109.65 | Facility | None | $23.99 | $23.99 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $109.65 | Professional | None | $23.99 | $23.99 | $109.65 |
AllWays Health Partners Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $269.15 | Facility | None | $51.29 | $53.70 | $269.15 |
AllWays Health Partners Setting Professional Modifier None Typical Low $22.91 Median $56.23 Typical High $288.40 | Professional | None | $22.91 | $56.23 | $288.40 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $61.66 Median $72.44 Typical High $95.50 | Facility | None | $61.66 | $72.44 | $95.50 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $36.31 | Professional | None | $35.48 | $35.48 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.88 | Professional | None | $23.99 | $23.99 | $33.88 |
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 $21.38 Median $46.77 Typical High $50.12 | Professional | None | $21.38 | $46.77 | $50.12 |
Health New England Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Health New England Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $269.15 | Facility | None | $51.29 | $53.70 | $269.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $22.91 Median $56.23 Typical High $288.40 | Professional | None | $22.91 | $56.23 | $288.40 |
United Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
United Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $53.70 | Professional | None | $18.20 | $27.54 | $53.70 |
Well Sense Setting Facility Modifier None Typical Low $43.65 Median $57.54 Typical High $85.11 | Facility | None | $43.65 | $57.54 | $85.11 |
Well Sense Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $40.74 | Professional | None | $33.88 | $33.88 | $40.74 |
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 $12.02 Median $12.02 Typical High $54.95 | Professional | 52 · Reduced service | $12.02 | $12.02 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $21.88 | Professional | 53 · Discontinued | $4.79 | $4.79 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $16.60 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $10.96 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $10.96 |
Where Massachusetts sits
The same service costs 2.6 times more in Montana than in Kansas. 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· 19th of 51
$37.15
MT $60.26KS $23.44
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.