How much rates vary
Facilitymedian $427 · 10th to 90th $251 to $1,349Professionalmedian $309 · 10th to 90th $170 to $2,570
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 $190.55 Median $190.55 Typical High $870.96 | Facility | None | $190.55 | $190.55 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $870.96 | Professional | None | $190.55 | $190.55 | $870.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $1,348.96 | Facility | None | $416.87 | $416.87 | $1,348.96 |
AllWays Health Partners Setting Professional Modifier None Typical Low $169.82 Median $446.68 Typical High $2,570.40 | Professional | None | $169.82 | $446.68 | $2,570.40 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $758.58 | Facility | None | $251.19 | $251.19 | $758.58 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $389.05 | Professional | None | $281.84 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $302.00 Typical High $302.00 | Facility | None | $251.19 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
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 $169.82 Median $380.19 Typical High $398.11 | Professional | None | $169.82 | $380.19 | $398.11 |
Health New England Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Mass General Brigham Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $1,348.96 | Facility | None | $416.87 | $416.87 | $1,348.96 |
Mass General Brigham Setting Professional Modifier None Typical Low $169.82 Median $446.68 Typical High $2,570.40 | Professional | None | $169.82 | $446.68 | $2,570.40 |
United Setting Facility Modifier None Typical Low $251.19 Median $549.54 Typical High $549.54 | Facility | None | $251.19 | $549.54 | $549.54 |
United Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $426.58 | Professional | None | $144.54 | $234.42 | $426.58 |
Well Sense Setting Facility Modifier None Typical Low $389.05 Median $524.81 Typical High $776.25 | Facility | None | $389.05 | $524.81 | $776.25 |
Well Sense Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | None | $281.84 | $281.84 | $338.84 |
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 $95.50 Median $95.50 Typical High $436.52 | Professional | 52 · Reduced service | $95.50 | $95.50 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $173.78 | Professional | 53 · Discontinued | $38.02 | $38.02 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $128.82 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $87.10 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $87.10 |
Where Massachusetts sits
The same service costs 2.5 times more in Hawaii than in Pennsylvania. 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· 17th of 51
$331
HI $550PA $219
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.