How much rates vary
Facilitymedian $89 · 10th to 90th $39 to $174Professionalmedian $51 · 10th to 90th $33 to $166
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 $38.90 Median $38.90 Typical High $177.83 | Facility | None | $38.90 | $38.90 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $151.36 | Professional | None | $38.90 | $38.90 | $151.36 |
AllWays Health Partners Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $275.42 | Facility | None | $70.79 | $83.18 | $275.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $33.11 Median $89.13 Typical High $524.81 | Professional | None | $33.11 | $89.13 | $524.81 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $89.13 Median $114.82 Typical High $154.88 | Facility | None | $89.13 | $114.82 | $154.88 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $87.10 | Professional | None | $41.69 | $51.29 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $51.29 | Facility | None | $45.71 | $45.71 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $46.77 | Professional | None | $33.11 | $33.11 | $46.77 |
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 $74.13 Typical High $79.43 | Professional | None | $29.51 | $74.13 | $79.43 |
Health New England Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Health New England Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $46.77 | Professional | None | $38.90 | $38.90 | $46.77 |
Mass General Brigham Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $275.42 | Facility | None | $70.79 | $83.18 | $275.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $33.11 Median $89.13 Typical High $524.81 | Professional | None | $33.11 | $89.13 | $524.81 |
Tufts Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $144.54 | Professional | None | $60.26 | $85.11 | $144.54 |
United Setting Facility Modifier None Typical Low $43.65 Median $52.48 Typical High $89.13 | Facility | None | $43.65 | $52.48 | $89.13 |
United Setting Professional Modifier None Typical Low $29.51 Median $43.65 Typical High $85.11 | Professional | None | $29.51 | $43.65 | $85.11 |
Well Sense Setting Facility Modifier None Typical Low $69.18 Median $93.33 Typical High $134.90 | Facility | None | $69.18 | $93.33 | $134.90 |
Well Sense Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | None | $53.70 | $53.70 | $64.57 |
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 $19.05 Median $19.05 Typical High $87.10 | Professional | 52 · Reduced service | $19.05 | $19.05 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $35.48 | Professional | 53 · Discontinued | $7.76 | $7.76 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $26.30 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $17.78 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $17.78 |
Where Massachusetts sits
The same service costs 3.8 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· 16th of 51
$58.88
HI $126FL $33.11
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.