How much rates vary
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 $4,570.88 Median $4,570.88 Typical High $20,892.96 | Facility | None | $4,570.88 | $4,570.88 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $20,892.96 | Professional | None | $4,570.88 | $4,570.88 | $20,892.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $9,332.54 Median $9,772.37 Typical High $30,199.52 | Facility | None | $9,332.54 | $9,772.37 | $30,199.52 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4,073.80 Median $10,471.29 Typical High $52,480.75 | Professional | None | $4,073.80 | $10,471.29 | $52,480.75 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $11,748.98 Median $13,489.63 Typical High $17,782.79 | Facility | None | $11,748.98 | $13,489.63 | $17,782.79 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $7,244.36 Median $9,120.11 Typical High $9,120.11 | Professional | None | $7,244.36 | $9,120.11 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $6,760.83 | Professional | None | $4,897.79 | $4,897.79 | $6,760.83 |
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 $4,073.80 Median $9,120.11 Typical High $9,332.54 | Professional | None | $4,073.80 | $9,120.11 | $9,332.54 |
Health New England Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $9,332.54 Median $9,772.37 Typical High $30,199.52 | Facility | None | $9,332.54 | $9,772.37 | $30,199.52 |
Mass General Brigham Setting Professional Modifier None Typical Low $4,073.80 Median $10,471.29 Typical High $52,480.75 | Professional | None | $4,073.80 | $10,471.29 | $52,480.75 |
United Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $5,495.41 Typical High $10,232.93 | Professional | None | $3,467.37 | $5,495.41 | $10,232.93 |
Well Sense Setting Facility Modifier None Typical Low $9,332.54 Median $12,302.69 Typical High $18,197.01 | Facility | None | $9,332.54 | $12,302.69 | $18,197.01 |
Well Sense Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $8,128.31 | Professional | None | $6,760.83 | $6,760.83 | $8,128.31 |
2 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 55 · Aftercare only Typical Low $676.08 Median $676.08 Typical High $3,090.30 | Professional | 55 · Aftercare only | $676.08 | $676.08 | $3,090.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $457.09 Typical High $2,089.30 | Professional | 56 · Pre-op care only | $457.09 | $457.09 | $2,089.30 |
Where Massachusetts sits
The same service costs 2.3 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
$8,511
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.