How much rates vary
Facilitymedian $851 · 10th to 90th $316 to $4,266Professionalmedian $589 · 10th to 90th $295 to $1,318
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 $602.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $602.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $812.83 | Professional | None | $245.47 | $295.12 | $812.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $1,778.28 Typical High $5,011.87 | Facility | None | $457.09 | $1,778.28 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $309.03 Median $741.31 Typical High $2,951.21 | Professional | None | $309.03 | $741.31 | $2,951.21 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $316.23 Median $389.05 Typical High $724.44 | Facility | None | $316.23 | $389.05 | $724.44 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $812.83 | Professional | None | $316.23 | $549.54 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,659.59 Typical High $2,398.83 | Facility | None | $588.84 | $1,659.59 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $954.99 | Professional | None | $354.81 | $446.68 | $954.99 |
Fallon Health Setting Facility Modifier None Typical Low $316.23 Median $416.87 Typical High $3,311.31 | Facility | None | $316.23 | $416.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $691.83 | Professional | None | $501.19 | $588.84 | $691.83 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $338.84 Median $724.44 Typical High $1,122.02 | Professional | None | $338.84 | $724.44 | $1,122.02 |
Health New England Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $1,778.28 Typical High $5,011.87 | Facility | None | $457.09 | $1,778.28 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $309.03 Median $741.31 Typical High $2,951.21 | Professional | None | $309.03 | $741.31 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $1,122.02 | Professional | None | $331.13 | $512.86 | $1,122.02 |
Well Sense Setting Facility Modifier None Typical Low $281.84 Median $407.38 Typical High $851.14 | Facility | None | $281.84 | $407.38 | $851.14 |
Well Sense Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $323.59 | Professional | None | $229.09 | $269.15 | $323.59 |
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 $120.23 Median $147.91 Typical High $407.38 | Professional | 52 · Reduced service | $120.23 | $147.91 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $58.88 Typical High $162.18 | Professional | 53 · Discontinued | $48.98 | $58.88 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $218.78 Typical High $602.56 | Professional | 54 · Surgery only | $181.97 | $218.78 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $44.67 Typical High $120.23 | Professional | 55 · Aftercare only | $36.31 | $44.67 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $29.51 Typical High $81.28 | Professional | 56 · Pre-op care only | $24.55 | $29.51 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $204.17 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $169.82 | $204.17 | $562.34 |
Where Massachusetts sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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
$603
AK $1,549NJ $347
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.