How much rates vary
Facilitymedian $331 · 10th to 90th $162 to $1,072Professionalmedian $224 · 10th to 90th $117 to $1,738
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 $151.36 Median $151.36 Typical High $691.83 | Facility | None | $151.36 | $151.36 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $691.83 | Professional | None | $151.36 | $151.36 | $691.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $257.04 Median $331.13 Typical High $1,071.52 | Facility | None | $257.04 | $331.13 | $1,071.52 |
AllWays Health Partners Setting Professional Modifier None Typical Low $134.90 Median $354.81 Typical High $1,737.80 | Professional | None | $134.90 | $354.81 | $1,737.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $602.56 | Facility | None | $199.53 | $199.53 | $602.56 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | None | $223.87 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $199.53 | Facility | None | $162.18 | $162.18 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | None | $117.49 | $117.49 | $162.18 |
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 $131.83 Median $302.00 Typical High $309.03 | Professional | None | $131.83 | $302.00 | $309.03 |
Health New England Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $257.04 Median $331.13 Typical High $1,071.52 | Facility | None | $257.04 | $331.13 | $1,071.52 |
Mass General Brigham Setting Professional Modifier None Typical Low $134.90 Median $354.81 Typical High $1,737.80 | Professional | None | $134.90 | $354.81 | $1,737.80 |
United Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $354.81 | Facility | None | $104.71 | $128.82 | $354.81 |
United Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $316.23 | Professional | None | $114.82 | $173.78 | $316.23 |
Well Sense Setting Facility Modifier None Typical Low $309.03 Median $416.87 Typical High $616.60 | Facility | None | $309.03 | $416.87 | $616.60 |
Well Sense Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $269.15 | Professional | None | $223.87 | $223.87 | $269.15 |
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 $75.86 Median $75.86 Typical High $346.74 | Professional | 52 · Reduced service | $75.86 | $75.86 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $138.04 | Professional | 53 · Discontinued | $30.20 | $30.20 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $102.33 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $69.18 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $69.18 |
Where Massachusetts sits
The same service costs 2.8 times more in Minnesota 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· 10th of 51
$251
MN $331DE $117
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.