How much rates vary
Facilitymedian $89 · 10th to 90th $47 to $158Professionalmedian $55 · 10th to 90th $32 to $162
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 $35.48 Median $35.48 Typical High $162.18 | Facility | None | $35.48 | $35.48 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $162.18 | Professional | None | $35.48 | $35.48 | $162.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $69.18 Median $77.62 Typical High $251.19 | Facility | None | $69.18 | $77.62 | $251.19 |
AllWays Health Partners Setting Professional Modifier None Typical Low $31.62 Median $83.18 Typical High $436.52 | Professional | None | $31.62 | $83.18 | $436.52 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $81.28 Median $104.71 Typical High $141.25 | Facility | None | $81.28 | $104.71 | $141.25 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $93.33 | Professional | None | $46.77 | $54.95 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $69.18 | Facility | None | $46.77 | $46.77 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $47.86 | Professional | None | $33.88 | $33.88 | $47.86 |
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 $29.51 Median $69.18 Typical High $74.13 | Professional | None | $29.51 | $69.18 | $74.13 |
Health New England Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Health New England Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | None | $41.69 | $41.69 | $43.65 |
Mass General Brigham Setting Facility Modifier None Typical Low $69.18 Median $77.62 Typical High $251.19 | Facility | None | $69.18 | $77.62 | $251.19 |
Mass General Brigham Setting Professional Modifier None Typical Low $31.62 Median $83.18 Typical High $436.52 | Professional | None | $31.62 | $83.18 | $436.52 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $89.13 | Facility | None | $43.65 | $43.65 | $89.13 |
United Setting Professional Modifier None Typical Low $26.92 Median $40.74 Typical High $77.62 | Professional | None | $26.92 | $40.74 | $77.62 |
Well Sense Setting Facility Modifier None Typical Low $63.10 Median $85.11 Typical High $125.89 | Facility | None | $63.10 | $85.11 | $125.89 |
Well Sense Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Professional | None | $50.12 | $50.12 | $60.26 |
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 $17.78 Median $17.78 Typical High $81.28 | Professional | 52 · Reduced service | $17.78 | $17.78 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $32.36 | Professional | 53 · Discontinued | $7.08 | $7.08 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $24.55 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $16.22 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $16.22 |
Where Massachusetts sits
The same service costs 3.1 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· 19th of 51
$54.95
HI $105FL $33.88
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.