How much rates vary
Facilitymedian $363 · 10th to 90th $166 to $2,884Professionalmedian $339 · 10th to 90th $174 to $741
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $457.09 | Professional | None | $134.90 | $169.82 | $457.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $794.33 Typical High $2,884.03 | Facility | None | $323.59 | $794.33 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $177.83 Median $426.58 Typical High $1,698.24 | Professional | None | $177.83 | $426.58 | $1,698.24 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $416.87 | Facility | None | $181.97 | $218.78 | $416.87 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $478.63 | Professional | None | $181.97 | $309.03 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $269.15 Typical High $489.78 | Facility | None | $199.53 | $269.15 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $575.44 | Professional | None | $204.17 | $269.15 | $575.44 |
Fallon Health Setting Facility Modifier None Typical Low $162.18 Median $223.87 Typical High $3,311.31 | Facility | None | $162.18 | $223.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $407.38 | Professional | None | $295.12 | $346.74 | $407.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $204.17 Median $416.87 Typical High $660.69 | Professional | None | $204.17 | $416.87 | $660.69 |
Health New England Setting Facility Modifier None Typical Low $89.13 Median $478.63 Typical High $1,412.54 | Facility | None | $89.13 | $478.63 | $1,412.54 |
Health New England Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $371.54 | Professional | None | $173.78 | $208.93 | $371.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $794.33 Typical High $2,884.03 | Facility | None | $323.59 | $794.33 | $2,884.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $177.83 Median $426.58 Typical High $1,698.24 | Professional | None | $177.83 | $426.58 | $1,698.24 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $5,370.32 | Facility | None | $407.38 | $870.96 | $5,370.32 |
United Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $645.65 | Professional | None | $194.98 | $302.00 | $645.65 |
Well Sense Setting Facility Modifier None Typical Low $117.49 Median $194.98 Typical High $316.23 | Facility | None | $117.49 | $194.98 | $316.23 |
Well Sense Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $190.55 | Professional | None | $125.89 | $151.36 | $190.55 |
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 $85.11 Typical High $229.09 | Professional | 52 · Reduced service | $67.61 | $85.11 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $33.88 Typical High $91.20 | Professional | 53 · Discontinued | $26.92 | $33.88 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $128.82 Typical High $338.84 | Professional | 54 · Surgery only | $102.33 | $128.82 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $25.70 Typical High $67.61 | Professional | 55 · Aftercare only | $20.42 | $25.70 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.98 Typical High $45.71 | Professional | 56 · Pre-op care only | $13.49 | $16.98 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $120.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $95.50 | $120.23 | $316.23 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $251.19 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $144.54 | $251.19 | $331.13 |
Where Massachusetts sits
The same service costs 3.9 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
$339
AK $724KY $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.