How much rates vary
Facilitymedian $269 · 10th to 90th $138 to $891Professionalmedian $186 · 10th to 90th $102 to $1,514
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 $123.03 Median $123.03 Typical High $562.34 | Facility | None | $123.03 | $123.03 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $562.34 | Professional | None | $123.03 | $123.03 | $562.34 |
AllWays Health Partners Setting Facility Modifier None Typical Low $234.42 Median $269.15 Typical High $891.25 | Facility | None | $234.42 | $269.15 | $891.25 |
AllWays Health Partners Setting Professional Modifier None Typical Low $112.20 Median $288.40 Typical High $1,513.56 | Professional | None | $112.20 | $288.40 | $1,513.56 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $501.19 | Facility | None | $165.96 | $165.96 | $501.19 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $251.19 | Professional | None | $204.17 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $165.96 | Facility | None | $138.04 | $138.04 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
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 $112.20 Median $251.19 Typical High $251.19 | Professional | None | $112.20 | $251.19 | $251.19 |
Health New England Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $234.42 Median $269.15 Typical High $891.25 | Facility | None | $234.42 | $269.15 | $891.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $112.20 Median $288.40 Typical High $1,513.56 | Professional | None | $112.20 | $288.40 | $1,513.56 |
United Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $302.00 | Facility | None | $147.91 | $154.88 | $302.00 |
United Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $257.04 | Professional | None | $95.50 | $141.25 | $257.04 |
Well Sense Setting Facility Modifier None Typical Low $257.04 Median $346.74 Typical High $501.19 | Facility | None | $257.04 | $346.74 | $501.19 |
Well Sense Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | None | $186.21 | $186.21 | $223.87 |
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 $61.66 Median $61.66 Typical High $281.84 | Professional | 52 · Reduced service | $61.66 | $61.66 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $114.82 | Professional | 53 · Discontinued | $25.12 | $25.12 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $85.11 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $56.23 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $56.23 |
Where Massachusetts sits
The same service costs 3.5 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· 14th of 51
$204
HI $363DE $102
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.