How much rates vary
Facilitymedian $11,749 · 10th to 90th $6,026 to $18,621Professionalmedian $7,413 · 10th to 90th $4,074 to $56,234
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 $10,000.00 Typical High $29,512.09 | Facility | None | $9,332.54 | $10,000.00 | $29,512.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4,073.80 Median $10,715.19 Typical High $56,234.13 | Professional | None | $4,073.80 | $10,715.19 | $56,234.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $10,471.29 Median $13,489.63 Typical High $18,197.01 | Facility | None | $10,471.29 | $13,489.63 | $18,197.01 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $6,760.83 Median $8,709.64 Typical High $8,709.64 | Professional | None | $6,760.83 | $8,709.64 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $6,025.60 Median $7,585.78 Typical High $7,585.78 | Facility | None | $6,025.60 | $7,585.78 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,585.78 | Professional | None | $5,495.41 | $5,495.41 | $7,585.78 |
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 $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $9,332.54 Median $10,000.00 Typical High $29,512.09 | Facility | None | $9,332.54 | $10,000.00 | $29,512.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $4,073.80 Median $10,715.19 Typical High $56,234.13 | Professional | None | $4,073.80 | $10,715.19 | $56,234.13 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $12,882.50 | Facility | None | $4,265.80 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $5,248.07 Typical High $9,549.93 | Professional | None | $3,467.37 | $5,248.07 | $9,549.93 |
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 |
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 $2,290.87 Median $2,290.87 Typical High $10,471.29 | Professional | 52 · Reduced service | $2,290.87 | $2,290.87 | $10,471.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $912.01 Typical High $4,168.69 | Professional | 53 · Discontinued | $912.01 | $912.01 | $4,168.69 |
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 2.1 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· 14th of 51
$8,511
MT $11,220PA $5,370
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.