How much rates vary
Facilitymedian $380 · 10th to 90th $138 to $2,399Professionalmedian $525 · 10th to 90th $234 to $1,259
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 $691.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $691.83 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $575.44 | Professional | None | $169.82 | $281.84 | $575.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $138.04 Median $489.78 Typical High $2,041.74 | Facility | None | $138.04 | $489.78 | $2,041.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $245.47 Median $549.54 Typical High $2,884.03 | Professional | None | $245.47 | $549.54 | $2,884.03 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $218.78 Median $269.15 Typical High $501.19 | Facility | None | $218.78 | $269.15 | $501.19 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $218.78 Median $457.09 Typical High $812.83 | Professional | None | $218.78 | $457.09 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $478.63 Typical High $776.25 | Facility | None | $338.84 | $478.63 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $977.24 | Professional | None | $269.15 | $478.63 | $977.24 |
Fallon Health Setting Facility Modifier None Typical Low $218.78 Median $288.40 Typical High $3,311.31 | Facility | None | $218.78 | $288.40 | $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 $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 $251.19 Median $524.81 Typical High $1,096.48 | Professional | None | $251.19 | $524.81 | $1,096.48 |
Health New England Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Health New England Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $138.04 Median $489.78 Typical High $2,041.74 | Facility | None | $138.04 | $489.78 | $2,041.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $245.47 Median $549.54 Typical High $2,884.03 | Professional | None | $245.47 | $549.54 | $2,884.03 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $239.88 Median $478.63 Typical High $1,071.52 | Professional | None | $239.88 | $478.63 | $1,071.52 |
Well Sense Setting Facility Modifier None Typical Low $138.04 Median $263.03 Typical High $446.68 | Facility | None | $138.04 | $263.03 | $446.68 |
Well Sense Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $309.03 | Professional | None | $162.18 | $194.98 | $309.03 |
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 $85.11 Median $141.25 Typical High $288.40 | Professional | 52 · Reduced service | $85.11 | $141.25 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $56.23 Typical High $117.49 | Professional | 53 · Discontinued | $33.88 | $56.23 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $213.80 Typical High $436.52 | Professional | 54 · Surgery only | $128.82 | $213.80 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $42.66 Typical High $87.10 | Professional | 55 · Aftercare only | $25.70 | $42.66 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $28.18 Typical High $57.54 | Professional | 56 · Pre-op care only | $16.98 | $28.18 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $199.53 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $120.23 | $199.53 | $407.38 |
Where Massachusetts sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 5th of 51
$513
AK $891MD $257
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.