How much rates vary
Facilitymedian $575 · 10th to 90th $186 to $3,311Professionalmedian $347 · 10th to 90th $182 to $776
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 $588.84 Median $2,691.53 Typical High $3,715.35 | Facility | None | $588.84 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $457.09 | Professional | None | $134.90 | $177.83 | $457.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $436.52 Median $1,096.48 Typical High $3,630.78 | Facility | None | $436.52 | $1,096.48 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $181.97 Median $436.52 Typical High $1,819.70 | Professional | None | $181.97 | $436.52 | $1,819.70 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $426.58 | Facility | None | $186.21 | $229.09 | $426.58 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $512.86 | Professional | None | $186.21 | $323.59 | $512.86 |
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 $204.17 Median $281.84 Typical High $588.84 | Professional | None | $204.17 | $281.84 | $588.84 |
Fallon Health Setting Facility Modifier None Typical Low $186.21 Median $245.47 Typical High $3,311.31 | Facility | None | $186.21 | $245.47 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $426.58 | Professional | None | $309.03 | $363.08 | $426.58 |
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 $199.53 Median $426.58 Typical High $691.83 | Professional | None | $199.53 | $426.58 | $691.83 |
Health New England Setting Facility Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $3,090.30 | Facility | None | $1,412.54 | $1,905.46 | $3,090.30 |
Health New England Setting Professional Modifier None Typical Low $173.78 Median $380.19 Typical High $380.19 | Professional | None | $173.78 | $380.19 | $380.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $436.52 Median $1,096.48 Typical High $3,630.78 | Facility | None | $436.52 | $1,096.48 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $181.97 Median $436.52 Typical High $1,819.70 | Professional | None | $181.97 | $436.52 | $1,819.70 |
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 $190.55 Median $309.03 Typical High $676.08 | Professional | None | $190.55 | $309.03 | $676.08 |
Well Sense Setting Facility Modifier None Typical Low $162.18 Median $251.19 Typical High $489.78 | Facility | None | $162.18 | $251.19 | $489.78 |
Well Sense Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $194.98 | Professional | None | $125.89 | $151.36 | $194.98 |
7 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 $67.61 Median $89.13 Typical High $229.09 | Professional | 52 · Reduced service | $67.61 | $89.13 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $35.48 Typical High $91.20 | Professional | 53 · Discontinued | $26.92 | $35.48 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $131.83 Typical High $338.84 | Professional | 54 · Surgery only | $102.33 | $131.83 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $26.92 Typical High $67.61 | Professional | 55 · Aftercare only | $20.42 | $26.92 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $17.78 Typical High $45.71 | Professional | 56 · Pre-op care only | $13.49 | $17.78 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $123.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $95.50 | $123.03 | $316.23 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $186.21 |
Where Massachusetts sits
The same service costs 4.7 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
$363
AK $871KY $186
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.