How much rates vary
Facilitymedian $288 · 10th to 90th $166 to $955Professionalmedian $219 · 10th to 90th $117 to $1,778
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 $131.83 Median $131.83 Typical High $602.56 | Facility | None | $131.83 | $131.83 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $602.56 | Professional | None | $131.83 | $131.83 | $602.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $275.42 Median $288.40 Typical High $954.99 | Facility | None | $275.42 | $288.40 | $954.99 |
AllWays Health Partners Setting Professional Modifier None Typical Low $117.49 Median $309.03 Typical High $1,778.28 | Professional | None | $117.49 | $309.03 | $1,778.28 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $537.03 | Facility | None | $173.78 | $173.78 | $537.03 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $269.15 | Professional | None | $218.78 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $186.21 | Facility | None | $165.96 | $165.96 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $169.82 | Professional | None | $120.23 | $120.23 | $169.82 |
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 $117.49 Median $263.03 Typical High $275.42 | Professional | None | $117.49 | $263.03 | $275.42 |
Health New England Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Mass General Brigham Setting Facility Modifier None Typical Low $275.42 Median $288.40 Typical High $954.99 | Facility | None | $275.42 | $288.40 | $954.99 |
Mass General Brigham Setting Professional Modifier None Typical Low $117.49 Median $309.03 Typical High $1,778.28 | Professional | None | $117.49 | $309.03 | $1,778.28 |
United Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $363.08 | Facility | None | $134.90 | $141.25 | $363.08 |
United Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $295.12 | Professional | None | $100.00 | $158.49 | $295.12 |
Well Sense Setting Facility Modifier None Typical Low $269.15 Median $363.08 Typical High $537.03 | Facility | None | $269.15 | $363.08 | $537.03 |
Well Sense Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | None | $199.53 | $199.53 | $239.88 |
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 $66.07 Median $66.07 Typical High $302.00 | Professional | 52 · Reduced service | $66.07 | $66.07 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $120.23 | Professional | 53 · Discontinued | $26.30 | $26.30 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $91.20 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $60.26 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $60.26 |
Where Massachusetts sits
The same service costs 2.8 times more in Montana 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· 16th of 51
$224
MT $331DE $120
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.