How much rates vary
Facilitymedian $170 · 10th to 90th $81 to $2,042Professionalmedian $200 · 10th to 90th $95 to $417
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 $91.20 Median $1,479.11 Typical High $3,388.44 | Facility | None | $91.20 | $1,479.11 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $263.03 | Professional | None | $74.13 | $93.33 | $263.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $64.57 Median $309.03 Typical High $1,862.09 | Facility | None | $64.57 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $97.72 Median $263.03 Typical High $954.99 | Professional | None | $97.72 | $263.03 | $954.99 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $269.15 | Facility | None | $117.49 | $141.25 | $269.15 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $269.15 | Professional | None | $117.49 | $199.53 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $158.49 Typical High $199.53 | Facility | None | $53.70 | $158.49 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $309.03 | Professional | None | $134.90 | $190.55 | $309.03 |
Fallon Health Setting Facility Modifier None Typical Low $104.71 Median $144.54 Typical High $3,311.31 | Facility | None | $104.71 | $144.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $229.09 | Professional | None | $162.18 | $190.55 | $229.09 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $371.54 | Professional | None | $120.23 | $251.19 | $371.54 |
Health New England Setting Facility Modifier None Typical Low $138.04 Median $245.47 Typical High $512.86 | Facility | None | $138.04 | $245.47 | $512.86 |
Health New England Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $239.88 | Professional | None | $173.78 | $190.55 | $239.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $64.57 Median $309.03 Typical High $1,862.09 | Facility | None | $64.57 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $97.72 Median $263.03 Typical High $954.99 | Professional | None | $97.72 | $263.03 | $954.99 |
Tufts Setting Facility Modifier None Typical Low $74.13 Median $263.03 Typical High $426.58 | Facility | None | $74.13 | $263.03 | $426.58 |
Tufts Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $245.47 | Professional | None | $97.72 | $134.90 | $245.47 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $371.54 | Professional | None | $93.33 | $162.18 | $371.54 |
Well Sense Setting Facility Modifier None Typical Low $64.57 Median $112.20 Typical High $186.21 | Facility | None | $64.57 | $112.20 | $186.21 |
Well Sense Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $95.50 | Professional | None | $67.61 | $79.43 | $95.50 |
8 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 $37.15 Median $44.67 Typical High $123.03 | Professional | 52 · Reduced service | $37.15 | $44.67 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.20 Typical High $48.98 | Professional | 53 · Discontinued | $14.79 | $18.20 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $67.61 Typical High $181.97 | Professional | 54 · Surgery only | $56.23 | $67.61 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.49 Typical High $36.31 | Professional | 55 · Aftercare only | $11.22 | $13.49 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.12 Typical High $24.55 | Professional | 56 · Pre-op care only | $7.41 | $9.12 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $63.10 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $52.48 | $63.10 | $169.82 |
BCBS Massachusetts Setting Facility Modifier 52 · Reduced service Typical Low $58.88 Median $60.26 Typical High $134.90 | Facility | 52 · Reduced service | $58.88 | $60.26 | $134.90 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $131.83 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $117.49 | $131.83 | $263.03 |
Where Massachusetts sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 9th of 51
$200
AK $437KY $100
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.