How much rates vary
Facilitymedian $617 · 10th to 90th $288 to $3,388Professionalmedian $550 · 10th to 90th $282 to $1,288
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 $724.44 Median $2,691.53 Typical High $3,715.35 | Facility | None | $724.44 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $724.44 | Professional | None | $213.80 | $302.00 | $724.44 |
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 $295.12 Median $660.69 Typical High $2,951.21 | Professional | None | $295.12 | $660.69 | $2,951.21 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $269.15 Median $323.59 Typical High $616.60 | Facility | None | $269.15 | $323.59 | $616.60 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $812.83 | Professional | None | $269.15 | $457.09 | $812.83 |
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 $309.03 Median $457.09 Typical High $954.99 | Professional | None | $309.03 | $457.09 | $954.99 |
Fallon Health Setting Facility Modifier None Typical Low $269.15 Median $354.81 Typical High $3,311.31 | Facility | None | $269.15 | $354.81 | $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 $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 $316.23 Median $630.96 Typical High $1,122.02 | Professional | None | $316.23 | $630.96 | $1,122.02 |
Health New England Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
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 $295.12 Median $660.69 Typical High $2,951.21 | Professional | None | $295.12 | $660.69 | $2,951.21 |
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 $309.03 Median $524.81 Typical High $1,096.48 | Professional | None | $309.03 | $524.81 | $1,096.48 |
Well Sense Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $588.84 | Facility | None | $251.19 | $407.38 | $588.84 |
Well Sense Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $338.84 | Professional | None | $204.17 | $245.47 | $338.84 |
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 $107.15 Median $151.36 Typical High $363.08 | Professional | 52 · Reduced service | $107.15 | $151.36 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $60.26 Typical High $144.54 | Professional | 53 · Discontinued | $42.66 | $60.26 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $223.87 Typical High $549.54 | Professional | 54 · Surgery only | $158.49 | $223.87 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $44.67 Typical High $109.65 | Professional | 55 · Aftercare only | $31.62 | $44.67 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $30.20 Typical High $72.44 | Professional | 56 · Pre-op care only | $21.38 | $30.20 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $208.93 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $147.91 | $208.93 | $512.86 |
Where Massachusetts sits
The same service costs 3.9 times more in Alaska than in Utah. 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
$562
AK $1,259UT $324
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.