How much rates vary
Facilitymedian $51,286 · 10th to 90th $30,200 to $79,433Professionalmedian $30,200 · 10th to 90th $17,783 to $245,471
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 $19,952.62 Median $19,952.62 Typical High $91,201.08 | Facility | None | $19,952.62 | $19,952.62 | $91,201.08 |
Aetna Setting Professional Modifier None Typical Low $19,952.62 Median $19,952.62 Typical High $91,201.08 | Professional | None | $19,952.62 | $19,952.62 | $91,201.08 |
AllWays Health Partners Setting Facility Modifier None Typical Low $39,810.72 Median $42,657.95 Typical High $128,824.96 | Facility | None | $39,810.72 | $42,657.95 | $128,824.96 |
AllWays Health Partners Setting Professional Modifier None Typical Low $17,782.79 Median $45,708.82 Typical High $245,470.89 | Professional | None | $17,782.79 | $45,708.82 | $245,470.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $51,286.14 Median $58,884.37 Typical High $77,624.71 | Facility | None | $51,286.14 | $58,884.37 | $77,624.71 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $29,512.09 Median $39,810.72 Typical High $39,810.72 | Professional | None | $29,512.09 | $39,810.72 | $39,810.72 |
Cigna Setting Facility Modifier None Typical Low $26,302.68 Median $30,199.52 Typical High $31,622.78 | Facility | None | $26,302.68 | $30,199.52 | $31,622.78 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $30,902.95 | Professional | None | $22,387.21 | $22,387.21 | $30,902.95 |
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 $17,782.79 Median $39,810.72 Typical High $40,738.03 | Professional | None | $17,782.79 | $39,810.72 | $40,738.03 |
Health New England Setting Professional Modifier None Typical Low $25,118.86 Median $25,118.86 Typical High $25,118.86 | Professional | None | $25,118.86 | $25,118.86 | $25,118.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $39,810.72 Median $42,657.95 Typical High $128,824.96 | Facility | None | $39,810.72 | $42,657.95 | $128,824.96 |
Mass General Brigham Setting Professional Modifier None Typical Low $17,782.79 Median $45,708.82 Typical High $245,470.89 | Professional | None | $17,782.79 | $45,708.82 | $245,470.89 |
United Setting Facility Modifier None Typical Low $53,703.18 Median $53,703.18 Typical High $53,703.18 | Facility | None | $53,703.18 | $53,703.18 | $53,703.18 |
United Setting Professional Modifier None Typical Low $15,135.61 Median $23,988.33 Typical High $43,651.58 | Professional | None | $15,135.61 | $23,988.33 | $43,651.58 |
Well Sense Setting Facility Modifier None Typical Low $40,738.03 Median $54,954.09 Typical High $79,432.82 | Facility | None | $40,738.03 | $54,954.09 | $79,432.82 |
Well Sense Setting Professional Modifier None Typical Low $29,512.09 Median $29,512.09 Typical High $35,481.34 | Professional | None | $29,512.09 | $29,512.09 | $35,481.34 |
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 $9,772.37 Median $9,772.37 Typical High $44,668.36 | Professional | 52 · Reduced service | $9,772.37 | $9,772.37 | $44,668.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,981.07 Median $3,981.07 Typical High $18,197.01 | Professional | 53 · Discontinued | $3,981.07 | $3,981.07 | $18,197.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,951.21 Median $2,951.21 Typical High $13,489.63 | Professional | 55 · Aftercare only | $2,951.21 | $2,951.21 | $13,489.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,995.26 Median $1,995.26 Typical High $9,120.11 | Professional | 56 · Pre-op care only | $1,995.26 | $1,995.26 | $9,120.11 |
Where Massachusetts sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 13th of 51
$37,154
HI $47,863NJ $22,387
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.