How much rates vary
Facilitymedian $427 · 10th to 90th $245 to $1,259Professionalmedian $295 · 10th to 90th $174 to $2,692
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 $194.98 Median $194.98 Typical High $891.25 | Facility | None | $194.98 | $194.98 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $891.25 | Professional | None | $194.98 | $194.98 | $891.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $363.08 Median $426.58 Typical High $1,258.93 | Facility | None | $363.08 | $426.58 | $1,258.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $173.78 Median $457.09 Typical High $2,691.53 | Professional | None | $173.78 | $457.09 | $2,691.53 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $776.25 | Facility | None | $257.04 | $257.04 | $776.25 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $398.11 | Professional | None | $323.59 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Facility | None | $245.47 | $245.47 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
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 $173.78 Median $389.05 Typical High $398.11 | Professional | None | $173.78 | $389.05 | $398.11 |
Health New England Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $363.08 Median $426.58 Typical High $1,258.93 | Facility | None | $363.08 | $426.58 | $1,258.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $173.78 Median $457.09 Typical High $2,691.53 | Professional | None | $173.78 | $457.09 | $2,691.53 |
United Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $478.63 | Facility | None | $234.42 | $281.84 | $478.63 |
United Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $407.38 | Professional | None | $147.91 | $223.87 | $407.38 |
Well Sense Setting Facility Modifier None Typical Low $398.11 Median $524.81 Typical High $794.33 | Facility | None | $398.11 | $524.81 | $794.33 |
Well Sense Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $346.74 | Professional | None | $288.40 | $288.40 | $346.74 |
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 $97.72 Median $97.72 Typical High $446.68 | Professional | 52 · Reduced service | $97.72 | $97.72 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $177.83 | Professional | 53 · Discontinued | $38.90 | $38.90 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $134.90 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $89.13 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $89.13 |
Where Massachusetts sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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· 15th of 51
$324
HI $646TN $178
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.