How much rates vary
Facilitymedian $10,233 · 10th to 90th $5,248 to $16,596Professionalmedian $6,310 · 10th to 90th $3,548 to $48,978
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 $3,981.07 Median $3,981.07 Typical High $18,197.01 | Facility | None | $3,981.07 | $3,981.07 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $18,197.01 | Professional | None | $3,981.07 | $3,981.07 | $18,197.01 |
AllWays Health Partners Setting Facility Modifier None Typical Low $8,128.31 Median $8,709.64 Typical High $25,703.96 | Facility | None | $8,128.31 | $8,709.64 | $25,703.96 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3,548.13 Median $9,332.54 Typical High $48,977.88 | Professional | None | $3,548.13 | $9,332.54 | $48,977.88 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $9,332.54 Median $11,748.98 Typical High $15,848.93 | Facility | None | $9,332.54 | $11,748.98 | $15,848.93 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $6,025.60 Median $8,128.31 Typical High $8,128.31 | Professional | None | $6,025.60 | $8,128.31 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $6,606.93 Typical High $6,606.93 | Facility | None | $5,248.07 | $6,606.93 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $6,606.93 | Professional | None | $4,786.30 | $4,786.30 | $6,606.93 |
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 $3,548.13 Median $7,943.28 Typical High $8,128.31 | Professional | None | $3,548.13 | $7,943.28 | $8,128.31 |
Health New England Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Mass General Brigham Setting Facility Modifier None Typical Low $8,128.31 Median $8,709.64 Typical High $25,703.96 | Facility | None | $8,128.31 | $8,709.64 | $25,703.96 |
Mass General Brigham Setting Professional Modifier None Typical Low $3,548.13 Median $9,332.54 Typical High $48,977.88 | Professional | None | $3,548.13 | $9,332.54 | $48,977.88 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $4,466.84 Typical High $10,964.78 | Facility | None | $3,801.89 | $4,466.84 | $10,964.78 |
United Setting Professional Modifier None Typical Low $3,019.95 Median $4,570.88 Typical High $8,317.64 | Professional | None | $3,019.95 | $4,570.88 | $8,317.64 |
Well Sense Setting Facility Modifier None Typical Low $8,128.31 Median $10,964.78 Typical High $16,218.10 | Facility | None | $8,128.31 | $10,964.78 | $16,218.10 |
Well Sense Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $7,079.46 | Professional | None | $6,025.60 | $6,025.60 | $7,079.46 |
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 $1,995.26 Median $1,995.26 Typical High $9,120.11 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $9,120.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $3,630.78 | Professional | 53 · Discontinued | $794.33 | $794.33 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $2,754.23 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $2,754.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $1,819.70 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $1,819.70 |
Where Massachusetts sits
The same service costs 2.1 times more in Montana 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· 12th of 51
$7,586
MT $10,000PA $4,786
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.