How much rates vary
Facilitymedian $120 · 10th to 90th $60 to $224Professionalmedian $76 · 10th to 90th $50 to $234
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 $51.29 Median $51.29 Typical High $234.42 | Facility | None | $51.29 | $51.29 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $173.78 | Professional | None | $51.29 | $51.29 | $173.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $97.72 Median $112.20 Typical High $363.08 | Facility | None | $97.72 | $112.20 | $363.08 |
AllWays Health Partners Setting Professional Modifier None Typical Low $45.71 Median $120.23 Typical High $851.14 | Professional | None | $45.71 | $120.23 | $851.14 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $117.49 Median $151.36 Typical High $204.17 | Facility | None | $117.49 | $151.36 | $204.17 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $128.82 | Professional | None | $67.61 | $75.86 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $75.86 | Facility | None | $67.61 | $67.61 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | None | $50.12 | $50.12 | $69.18 |
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 $44.67 Median $100.00 Typical High $107.15 | Professional | None | $44.67 | $100.00 | $107.15 |
Health New England Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Health New England Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $63.10 | Professional | None | $60.26 | $60.26 | $63.10 |
Mass General Brigham Setting Facility Modifier None Typical Low $97.72 Median $112.20 Typical High $363.08 | Facility | None | $97.72 | $112.20 | $363.08 |
Mass General Brigham Setting Professional Modifier None Typical Low $45.71 Median $120.23 Typical High $851.14 | Professional | None | $45.71 | $120.23 | $851.14 |
Tufts Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | None | $79.43 | $79.43 | $91.20 |
United Setting Facility Modifier None Typical Low $67.61 Median $77.62 Typical High $138.04 | Facility | None | $67.61 | $77.62 | $138.04 |
United Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $112.20 | Professional | None | $38.90 | $58.88 | $112.20 |
Well Sense Setting Facility Modifier None Typical Low $91.20 Median $123.03 Typical High $181.97 | Facility | None | $91.20 | $123.03 | $181.97 |
Well Sense Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $87.10 | Professional | None | $72.44 | $72.44 | $87.10 |
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 $25.70 Median $25.70 Typical High $117.49 | Professional | 52 · Reduced service | $25.70 | $25.70 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $46.77 | Professional | 53 · Discontinued | $10.23 | $10.23 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $34.67 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $23.44 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $23.44 |
Where Massachusetts sits
The same service costs 4.1 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· 21st of 51
$75.86
HI $209DE $51.29
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.