How much rates vary
Facilitymedian $575 · 10th to 90th $295 to $1,023Professionalmedian $339 · 10th to 90th $195 to $2,239
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 $218.78 Median $218.78 Typical High $1,000.00 | Facility | None | $218.78 | $218.78 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $1,000.00 | Professional | None | $218.78 | $218.78 | $1,000.00 |
AllWays Health Partners Setting Facility Modifier None Typical Low $389.05 Median $478.63 Typical High $1,071.52 | Facility | None | $389.05 | $478.63 | $1,071.52 |
AllWays Health Partners Setting Professional Modifier None Typical Low $194.98 Median $512.86 Typical High $2,238.72 | Professional | None | $194.98 | $512.86 | $2,238.72 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $562.34 Median $660.69 Typical High $870.96 | Facility | None | $562.34 | $660.69 | $870.96 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | None | $295.12 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $354.81 | Facility | None | $295.12 | $295.12 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $302.00 | Professional | None | $213.80 | $213.80 | $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 $190.55 Median $446.68 Typical High $446.68 | Professional | None | $190.55 | $446.68 | $446.68 |
Health New England Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Health New England Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $389.05 Median $478.63 Typical High $1,071.52 | Facility | None | $389.05 | $478.63 | $1,071.52 |
Mass General Brigham Setting Professional Modifier None Typical Low $194.98 Median $512.86 Typical High $2,238.72 | Professional | None | $194.98 | $512.86 | $2,238.72 |
United Setting Facility Modifier None Typical Low $186.21 Median $251.19 Typical High $512.86 | Facility | None | $186.21 | $251.19 | $512.86 |
United Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $457.09 | Professional | None | $169.82 | $251.19 | $457.09 |
Well Sense Setting Facility Modifier None Typical Low $338.84 Median $467.74 Typical High $676.08 | Facility | None | $338.84 | $467.74 | $676.08 |
Well Sense Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $371.54 | Professional | None | $309.03 | $309.03 | $371.54 |
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 $109.65 Median $109.65 Typical High $501.19 | Professional | 52 · Reduced service | $109.65 | $109.65 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $199.53 | Professional | 53 · Discontinued | $43.65 | $43.65 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $151.36 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $100.00 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $100.00 |
Where Massachusetts sits
The same service costs 2.5 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· 10th of 51
$389
HI $513DC $209
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.