How much rates vary
Facilitymedian $437 · 10th to 90th $214 to $2,754Professionalmedian $550 · 10th to 90th $251 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 $1,023.29 Median $2,818.38 Typical High $4,677.35 | Facility | None | $1,023.29 | $2,818.38 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $741.31 | Professional | None | $190.55 | $302.00 | $741.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $213.80 Median $524.81 Typical High $2,041.74 | Facility | None | $213.80 | $524.81 | $2,041.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $275.42 Median $588.84 Typical High $2,884.03 | Professional | None | $275.42 | $588.84 | $2,884.03 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $239.88 Median $288.40 Typical High $549.54 | Facility | None | $239.88 | $288.40 | $549.54 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $239.88 Median $457.09 Typical High $812.83 | Professional | None | $239.88 | $457.09 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $724.44 Typical High $954.99 | Facility | None | $616.60 | $724.44 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $549.54 Typical High $1,000.00 | Professional | None | $302.00 | $549.54 | $1,000.00 |
Fallon Health Setting Facility Modifier None Typical Low $234.42 Median $309.03 Typical High $3,311.31 | Facility | None | $234.42 | $309.03 | $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 $295.12 Median $562.34 Typical High $1,122.02 | Professional | None | $295.12 | $562.34 | $1,122.02 |
Health New England Setting Facility Modifier None Typical Low $75.86 Median $537.03 Typical High $4,466.84 | Facility | None | $75.86 | $537.03 | $4,466.84 |
Health New England Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $1,348.96 | Professional | None | $309.03 | $407.38 | $1,348.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $213.80 Median $524.81 Typical High $2,041.74 | Facility | None | $213.80 | $524.81 | $2,041.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $275.42 Median $588.84 Typical High $2,884.03 | Professional | None | $275.42 | $588.84 | $2,884.03 |
Tufts Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $741.31 | Professional | None | $316.23 | $457.09 | $741.31 |
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 $288.40 Median $524.81 Typical High $1,122.02 | Professional | None | $288.40 | $524.81 | $1,122.02 |
Well Sense Setting Facility Modifier None Typical Low $213.80 Median $309.03 Typical High $467.74 | Facility | None | $213.80 | $309.03 | $467.74 |
Well Sense Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $346.74 | Professional | None | $204.17 | $245.47 | $346.74 |
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 $95.50 Median $151.36 Typical High $371.54 | Professional | 52 · Reduced service | $95.50 | $151.36 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $61.66 Typical High $147.91 | Professional | 53 · Discontinued | $38.02 | $61.66 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $229.09 Typical High $562.34 | Professional | 54 · Surgery only | $144.54 | $229.09 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $45.71 Typical High $112.20 | Professional | 55 · Aftercare only | $28.84 | $45.71 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $30.20 Typical High $74.13 | Professional | 56 · Pre-op care only | $19.05 | $30.20 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $213.80 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $134.90 | $213.80 | $524.81 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $630.96 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $371.54 | $630.96 | $851.14 |
Where Massachusetts sits
The same service costs 3.3 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· 7th of 51
$537
AK $1,000UT $302
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.