How much rates vary
Facilitymedian $5,012 · 10th to 90th $2,692 to $8,710Professionalmedian $3,162 · 10th to 90th $1,698 to $22,909
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 $1,905.46 Median $1,905.46 Typical High $8,709.64 | Facility | None | $1,905.46 | $1,905.46 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $8,709.64 | Professional | None | $1,905.46 | $1,905.46 | $8,709.64 |
AllWays Health Partners Setting Facility Modifier None Typical Low $4,073.80 Median $4,168.69 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,168.69 | $12,302.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,698.24 Median $4,466.84 Typical High $22,908.68 | Professional | None | $1,698.24 | $4,466.84 | $22,908.68 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $4,466.84 Median $5,623.41 Typical High $7,585.78 | Facility | None | $4,466.84 | $5,623.41 | $7,585.78 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $3,162.28 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,162.28 | $3,890.45 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,754.23 | Facility | None | $2,511.89 | $2,511.89 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,819.70 | $1,819.70 | $2,511.89 |
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 $1,698.24 Median $3,801.89 Typical High $3,981.07 | Professional | None | $1,698.24 | $3,801.89 | $3,981.07 |
Health New England Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Mass General Brigham Setting Facility Modifier None Typical Low $4,073.80 Median $4,168.69 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,168.69 | $12,302.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,698.24 Median $4,466.84 Typical High $22,908.68 | Professional | None | $1,698.24 | $4,466.84 | $22,908.68 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $5,495.41 Typical High $5,495.41 | Facility | None | $2,187.76 | $5,495.41 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $4,265.80 | Professional | None | $1,445.44 | $2,344.23 | $4,265.80 |
Well Sense Setting Facility Modifier None Typical Low $3,890.45 Median $5,248.07 Typical High $7,762.47 | Facility | None | $3,890.45 | $5,248.07 | $7,762.47 |
Well Sense Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,388.44 | Professional | None | $2,818.38 | $2,818.38 | $3,388.44 |
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 $954.99 Median $954.99 Typical High $4,365.16 | Professional | 52 · Reduced service | $954.99 | $954.99 | $4,365.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $1,737.80 | Professional | 53 · Discontinued | $380.19 | $380.19 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $1,318.26 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $870.96 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $870.96 |
Where Massachusetts sits
The same service costs 2.6 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
$3,631
HI $4,786DE $1,820
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.