How much rates vary
Facilitymedian $62 · 10th to 90th $24 to $117Professionalmedian $39 · 10th to 90th $25 to $120
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 $26.30 Median $26.30 Typical High $120.23 | Facility | None | $26.30 | $26.30 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $120.23 | Professional | None | $26.30 | $26.30 | $120.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $56.23 Median $57.54 Typical High $186.21 | Facility | None | $56.23 | $57.54 | $186.21 |
AllWays Health Partners Setting Professional Modifier None Typical Low $24.55 Median $61.66 Typical High $316.23 | Professional | None | $24.55 | $61.66 | $316.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $67.61 Median $77.62 Typical High $104.71 | Facility | None | $67.61 | $77.62 | $104.71 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $31.62 Median $38.90 Typical High $66.07 | Professional | None | $31.62 | $38.90 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | None | $25.12 | $25.12 | $34.67 |
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 $22.91 Median $51.29 Typical High $54.95 | Professional | None | $22.91 | $51.29 | $54.95 |
Health New England Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Health New England Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Mass General Brigham Setting Facility Modifier None Typical Low $56.23 Median $57.54 Typical High $186.21 | Facility | None | $56.23 | $57.54 | $186.21 |
Mass General Brigham Setting Professional Modifier None Typical Low $24.55 Median $61.66 Typical High $316.23 | Professional | None | $24.55 | $61.66 | $316.23 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $19.95 Median $30.20 Typical High $58.88 | Professional | None | $19.95 | $30.20 | $58.88 |
Well Sense Setting Facility Modifier None Typical Low $40.74 Median $56.23 Typical High $79.43 | Facility | None | $40.74 | $56.23 | $79.43 |
Well Sense Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $41.69 | Professional | None | $34.67 | $34.67 | $41.69 |
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 $13.18 Median $13.18 Typical High $60.26 | Professional | 52 · Reduced service | $13.18 | $13.18 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $23.99 | Professional | 53 · Discontinued | $5.25 | $5.25 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $17.78 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $12.02 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $12.02 |
Where Massachusetts sits
The same service costs 2.8 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
$40.74
MT $64.57KS $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.