How much rates vary
Facilitymedian $603 · 10th to 90th $257 to $3,548Professionalmedian $468 · 10th to 90th $234 to $1,047
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 $338.84 Median $2,570.40 Typical High $3,630.78 | Facility | None | $338.84 | $2,570.40 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $588.84 | Professional | None | $181.97 | $234.42 | $588.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $3,630.78 | Facility | None | $446.68 | $1,096.48 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $245.47 Median $602.56 Typical High $2,454.71 | Professional | None | $245.47 | $602.56 | $2,454.71 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $588.84 | Facility | None | $257.04 | $309.03 | $588.84 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $257.04 Median $426.58 Typical High $676.08 | Professional | None | $257.04 | $426.58 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,445.44 | Facility | None | $588.84 | $1,000.00 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $794.33 | Professional | None | $275.42 | $371.54 | $794.33 |
Fallon Health Setting Facility Modifier None Typical Low $257.04 Median $331.13 Typical High $3,311.31 | Facility | None | $257.04 | $331.13 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $588.84 | Professional | None | $416.87 | $489.78 | $588.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $275.42 Median $588.84 Typical High $954.99 | Professional | None | $275.42 | $588.84 | $954.99 |
Health New England Setting Facility Modifier None Typical Low $1,348.96 Median $3,311.31 Typical High $5,128.61 | Facility | None | $1,348.96 | $3,311.31 | $5,128.61 |
Health New England Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $512.86 | Professional | None | $295.12 | $512.86 | $512.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $3,630.78 | Facility | None | $446.68 | $1,096.48 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $245.47 Median $602.56 Typical High $2,454.71 | Professional | None | $245.47 | $602.56 | $2,454.71 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,456.54 | Facility | None | $575.44 | $1,380.38 | $6,456.54 |
United Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $891.25 | Professional | None | $229.09 | $416.87 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $223.87 Median $338.84 Typical High $489.78 | Facility | None | $223.87 | $338.84 | $489.78 |
Well Sense Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $257.04 | Professional | None | $169.82 | $204.17 | $257.04 |
6 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 $91.20 Median $117.49 Typical High $295.12 | Professional | 52 · Reduced service | $91.20 | $117.49 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $46.77 Typical High $117.49 | Professional | 53 · Discontinued | $36.31 | $46.77 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $177.83 Typical High $446.68 | Professional | 54 · Surgery only | $138.04 | $177.83 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $35.48 Typical High $89.13 | Professional | 55 · Aftercare only | $27.54 | $35.48 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.44 Typical High $58.88 | Professional | 56 · Pre-op care only | $18.20 | $23.44 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $165.96 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $128.82 | $165.96 | $416.87 |
Where Massachusetts sits
The same service costs 4.8 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· 8th of 51
$479
AK $1,202KY $251
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.