How much rates vary
Facilitymedian $55 · 10th to 90th $35 to $102Professionalmedian $34 · 10th to 90th $17 to $324
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 $19.50 Median $19.50 Typical High $89.13 | Facility | None | $19.50 | $19.50 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $89.13 | Professional | None | $19.50 | $19.50 | $89.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $42.66 Median $45.71 Typical High $138.04 | Facility | None | $42.66 | $45.71 | $138.04 |
AllWays Health Partners Setting Professional Modifier None Typical Low $17.38 Median $45.71 Typical High $323.59 | Professional | None | $17.38 | $45.71 | $323.59 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $50.12 Median $57.54 Typical High $77.62 | Facility | None | $50.12 | $57.54 | $77.62 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $26.30 Median $38.90 Typical High $38.90 | Professional | None | $26.30 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $34.67 Typical High $34.67 | Facility | None | $25.70 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | None | $25.70 | $25.70 | $35.48 |
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 $17.38 Median $38.90 Typical High $40.74 | Professional | None | $17.38 | $38.90 | $40.74 |
Health New England Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Health New England Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $42.66 Median $45.71 Typical High $138.04 | Facility | None | $42.66 | $45.71 | $138.04 |
Mass General Brigham Setting Professional Modifier None Typical Low $17.38 Median $45.71 Typical High $323.59 | Professional | None | $17.38 | $45.71 | $323.59 |
Tufts Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $38.02 | Professional | None | $30.20 | $34.67 | $38.02 |
United Setting Facility Modifier None Typical Low $16.22 Median $31.62 Typical High $60.26 | Facility | None | $16.22 | $31.62 | $60.26 |
United Setting Professional Modifier None Typical Low $14.79 Median $23.99 Typical High $43.65 | Professional | None | $14.79 | $23.99 | $43.65 |
Well Sense Setting Facility Modifier None Typical Low $34.67 Median $45.71 Typical High $69.18 | Facility | None | $34.67 | $45.71 | $69.18 |
Well Sense Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $33.11 | Professional | None | $27.54 | $27.54 | $33.11 |
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 $9.77 Median $9.77 Typical High $44.67 | Professional | 52 · Reduced service | $9.77 | $9.77 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $17.78 | Professional | 53 · Discontinued | $3.89 | $3.89 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $13.49 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $8.91 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $8.91 |
Where Massachusetts sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 19th of 51
$37.15
HI $77.62DC $24.55
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.