How much rates vary
Facilitymedian $145 · 10th to 90th $85 to $468Professionalmedian $89 · 10th to 90th $56 to $676
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 $66.07 Median $66.07 Typical High $302.00 | Facility | None | $66.07 | $66.07 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $302.00 | Professional | None | $66.07 | $66.07 | $302.00 |
AllWays Health Partners Setting Facility Modifier None Typical Low $112.20 Median $144.54 Typical High $478.63 | Facility | None | $112.20 | $144.54 | $478.63 |
AllWays Health Partners Setting Professional Modifier None Typical Low $56.23 Median $154.88 Typical High $676.08 | Professional | None | $56.23 | $154.88 | $676.08 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $269.15 | Facility | None | $87.10 | $87.10 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $91.20 | Facility | None | $85.11 | $85.11 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $85.11 | Professional | None | $61.66 | $61.66 | $85.11 |
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 $51.29 Median $128.82 Typical High $138.04 | Professional | None | $51.29 | $128.82 | $138.04 |
Health New England Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $112.20 Median $144.54 Typical High $478.63 | Facility | None | $112.20 | $144.54 | $478.63 |
Mass General Brigham Setting Professional Modifier None Typical Low $56.23 Median $154.88 Typical High $676.08 | Professional | None | $56.23 | $154.88 | $676.08 |
United Setting Facility Modifier None Typical Low $48.98 Median $64.57 Typical High $154.88 | Facility | None | $48.98 | $64.57 | $154.88 |
United Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $147.91 | Professional | None | $50.12 | $75.86 | $147.91 |
Well Sense Setting Facility Modifier None Typical Low $134.90 Median $181.97 Typical High $269.15 | Facility | None | $134.90 | $181.97 | $269.15 |
Well Sense Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | None | $100.00 | $100.00 | $117.49 |
5 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 $33.11 Median $33.11 Typical High $151.36 | Professional | 52 · Reduced service | $33.11 | $33.11 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $60.26 | Professional | 53 · Discontinued | $13.18 | $13.18 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $45.71 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $30.20 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $30.20 |
BCBS Massachusetts Setting Professional Modifier RA · Replacement item Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | RA · Replacement item | $100.00 | $117.49 | $117.49 |
Where Massachusetts sits
The same service costs 2.2 times more in Hawaii than in Alabama. 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· 11th of 51
$110
HI $138AL $61.66
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.