How much rates vary
Facilitymedian $282 · 10th to 90th $120 to $851Professionalmedian $186 · 10th to 90th $105 to $479
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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $177.83 | Professional | None | $117.49 | $117.49 | $177.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $251.19 Median $257.04 Typical High $851.14 | Facility | None | $251.19 | $257.04 | $851.14 |
AllWays Health Partners Setting Professional Modifier None Typical Low $120.23 Median $275.42 Typical High $1,412.54 | Professional | None | $120.23 | $275.42 | $1,412.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $354.81 Median $426.58 Typical High $954.99 | Facility | None | $354.81 | $426.58 | $954.99 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $316.23 | Professional | None | $173.78 | $186.21 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $144.54 | Facility | None | $141.25 | $141.25 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
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 $104.71 Median $229.09 Typical High $245.47 | Professional | None | $104.71 | $229.09 | $245.47 |
Health New England Setting Facility Modifier None Typical Low $120.23 Median $162.18 Typical High $162.18 | Facility | None | $120.23 | $162.18 | $162.18 |
Health New England Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | None | $162.18 | $162.18 | $165.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $251.19 Median $257.04 Typical High $851.14 | Facility | None | $251.19 | $257.04 | $851.14 |
Mass General Brigham Setting Professional Modifier None Typical Low $120.23 Median $275.42 Typical High $1,412.54 | Professional | None | $120.23 | $275.42 | $1,412.54 |
Tufts Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $263.03 | Professional | None | $89.13 | $134.90 | $263.03 |
Well Sense Setting Facility Modifier None Typical Low $208.93 Median $281.84 Typical High $426.58 | Facility | None | $208.93 | $281.84 | $426.58 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $58.88 Median $58.88 Typical High $79.43 | Professional | 52 · Reduced service | $58.88 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $31.62 | Professional | 53 · Discontinued | $23.44 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $23.44 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $15.85 |
Where Massachusetts sits
The same service costs 2.2 times more in Hawaii than in Delaware. 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· 22nd of 51
$186
HI $275DE $126
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.