How much rates vary
Facilitymedian $776 · 10th to 90th $457 to $2,399Professionalmedian $603 · 10th to 90th $309 to $5,370
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 $346.74 Median $346.74 Typical High $1,584.89 | Facility | None | $346.74 | $346.74 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $1,584.89 | Professional | None | $346.74 | $346.74 | $1,584.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $2,454.71 | Facility | None | $758.58 | $776.25 | $2,454.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $309.03 Median $812.83 Typical High $5,370.32 | Professional | None | $309.03 | $812.83 | $5,370.32 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $1,380.38 | Facility | None | $457.09 | $457.09 | $1,380.38 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $707.95 | Professional | None | $512.86 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $588.84 | Facility | None | $457.09 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $602.56 | Professional | None | $426.58 | $426.58 | $602.56 |
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 $309.03 Median $691.83 Typical High $724.44 | Professional | None | $309.03 | $691.83 | $724.44 |
Health New England Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $2,454.71 | Facility | None | $758.58 | $776.25 | $2,454.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $309.03 Median $812.83 Typical High $5,370.32 | Professional | None | $309.03 | $812.83 | $5,370.32 |
United Setting Facility Modifier None Typical Low $181.97 Median $398.11 Typical High $1,071.52 | Facility | None | $181.97 | $398.11 | $1,071.52 |
United Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $776.25 | Professional | None | $263.03 | $426.58 | $776.25 |
Well Sense Setting Facility Modifier None Typical Low $707.95 Median $954.99 Typical High $1,412.54 | Facility | None | $707.95 | $954.99 | $1,412.54 |
Well Sense Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | None | $512.86 | $512.86 | $616.60 |
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 $173.78 Median $173.78 Typical High $794.33 | Professional | 52 · Reduced service | $173.78 | $173.78 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $316.23 | Professional | 53 · Discontinued | $69.18 | $69.18 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $234.42 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $158.49 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $158.49 |
Where Massachusetts sits
The same service costs 2.5 times more in Montana 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· 14th of 51
$617
MT $1,072AL $427
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.