How much rates vary
Facilitymedian $219 · 10th to 90th $115 to $2,239Professionalmedian $263 · 10th to 90th $126 to $603
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 $281.84 Median $2,137.96 Typical High $3,630.78 | Facility | None | $281.84 | $2,137.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $177.83 Typical High $346.74 | Professional | None | $100.00 | $177.83 | $346.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $177.83 Median $446.68 Typical High $1,819.70 | Facility | None | $177.83 | $446.68 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $131.83 Median $288.40 Typical High $1,380.38 | Professional | None | $131.83 | $288.40 | $1,380.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $117.49 Median $144.54 Typical High $269.15 | Facility | None | $117.49 | $144.54 | $269.15 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $117.49 Median $218.78 Typical High $380.19 | Professional | None | $117.49 | $218.78 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $173.78 Typical High $245.47 | Facility | None | $53.70 | $173.78 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $478.63 | Professional | None | $134.90 | $245.47 | $478.63 |
Fallon Health Setting Facility Modifier None Typical Low $107.15 Median $147.91 Typical High $3,311.31 | Facility | None | $107.15 | $147.91 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $331.13 | Professional | None | $239.88 | $281.84 | $331.13 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $141.25 Median $275.42 Typical High $524.81 | Professional | None | $141.25 | $275.42 | $524.81 |
Health New England Setting Facility Modifier None Typical Low $117.49 Median $223.87 Typical High $933.25 | Facility | None | $117.49 | $223.87 | $933.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $177.83 Median $446.68 Typical High $1,819.70 | Facility | None | $177.83 | $446.68 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $131.83 Median $288.40 Typical High $1,380.38 | Professional | None | $131.83 | $288.40 | $1,380.38 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,818.38 | Facility | None | $123.03 | $549.54 | $2,818.38 |
United Setting Professional Modifier None Typical Low $131.83 Median $251.19 Typical High $524.81 | Professional | None | $131.83 | $251.19 | $524.81 |
Well Sense Setting Facility Modifier None Typical Low $100.00 Median $169.82 Typical High $269.15 | Facility | None | $100.00 | $169.82 | $269.15 |
Well Sense Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $181.97 | Professional | None | $93.33 | $112.20 | $181.97 |
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 $50.12 Median $89.13 Typical High $173.78 | Professional | 52 · Reduced service | $50.12 | $89.13 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $35.48 Typical High $69.18 | Professional | 53 · Discontinued | $19.95 | $35.48 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $134.90 Typical High $257.04 | Professional | 54 · Surgery only | $75.86 | $134.90 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $26.92 Typical High $51.29 | Professional | 55 · Aftercare only | $15.14 | $26.92 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $17.78 Typical High $34.67 | Professional | 56 · Pre-op care only | $10.00 | $17.78 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $125.89 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $70.79 | $125.89 | $239.88 |
Where Massachusetts sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 7th of 51
$263
AK $490FL $138
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.