How much rates vary
Facilitymedian $427 · 10th to 90th $214 to $2,692Professionalmedian $575 · 10th to 90th $269 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 $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 $199.53 Median $331.13 Typical High $851.14 | Professional | None | $199.53 | $331.13 | $851.14 |
AllWays Health Partners Setting Facility Modifier None Typical Low $199.53 Median $537.03 Typical High $2,041.74 | Facility | None | $199.53 | $537.03 | $2,041.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $288.40 Median $616.60 Typical High $3,090.30 | Professional | None | $288.40 | $616.60 | $3,090.30 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $239.88 Median $295.12 Typical High $549.54 | Facility | None | $239.88 | $295.12 | $549.54 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $239.88 Median $489.78 Typical High $870.96 | Professional | None | $239.88 | $489.78 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $478.63 Typical High $954.99 | Facility | None | $338.84 | $478.63 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $1,071.52 | Professional | None | $316.23 | $562.34 | $1,071.52 |
Fallon Health Setting Facility Modifier None Typical Low $239.88 Median $316.23 Typical High $3,311.31 | Facility | None | $239.88 | $316.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $741.31 | Professional | None | $537.03 | $630.96 | $741.31 |
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 $316.23 Median $602.56 Typical High $1,174.90 | Professional | None | $316.23 | $602.56 | $1,174.90 |
Health New England Setting Facility Modifier None Typical Low $120.23 Median $691.83 Typical High $1,659.59 | Facility | None | $120.23 | $691.83 | $1,659.59 |
Health New England Setting Professional Modifier None Typical Low $338.84 Median $676.08 Typical High $691.83 | Professional | None | $338.84 | $676.08 | $691.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $199.53 Median $537.03 Typical High $2,041.74 | Facility | None | $199.53 | $537.03 | $2,041.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $288.40 Median $616.60 Typical High $3,090.30 | Professional | None | $288.40 | $616.60 | $3,090.30 |
Tufts Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $831.76 | Professional | None | $346.74 | $501.19 | $831.76 |
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 $302.00 Median $562.34 Typical High $1,202.26 | Professional | None | $302.00 | $562.34 | $1,202.26 |
Well Sense Setting Facility Modifier None Typical Low $208.93 Median $323.59 Typical High $501.19 | Facility | None | $208.93 | $323.59 | $501.19 |
Well Sense Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $389.05 | Professional | None | $234.42 | $281.84 | $389.05 |
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 $100.00 Median $165.96 Typical High $426.58 | Professional | 52 · Reduced service | $100.00 | $165.96 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $66.07 Typical High $169.82 | Professional | 53 · Discontinued | $39.81 | $66.07 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $245.47 Typical High $630.96 | Professional | 54 · Surgery only | $151.36 | $245.47 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $48.98 Typical High $125.89 | Professional | 55 · Aftercare only | $30.20 | $48.98 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $33.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $19.95 | $33.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $229.09 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $141.25 | $229.09 | $588.84 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $676.08 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $398.11 | $676.08 | $891.25 |
Where Massachusetts sits
The same service costs 3.2 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
$562
AK $1,047FL $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.