How much rates vary
Facilitymedian $389 · 10th to 90th $138 to $2,570Professionalmedian $537 · 10th to 90th $245 to $1,230
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 $186.21 Median $295.12 Typical High $724.44 | Professional | None | $186.21 | $295.12 | $724.44 |
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 $269.15 Median $575.44 Typical High $2,884.03 | Professional | None | $269.15 | $575.44 | $2,884.03 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $229.09 Median $275.42 Typical High $524.81 | Facility | None | $229.09 | $275.42 | $524.81 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $229.09 Median $457.09 Typical High $794.33 | Professional | None | $229.09 | $457.09 | $794.33 |
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 $295.12 Median $537.03 Typical High $977.24 | Professional | None | $295.12 | $537.03 | $977.24 |
Fallon Health Setting Facility Modifier None Typical Low $229.09 Median $302.00 Typical High $3,311.31 | Facility | None | $229.09 | $302.00 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $676.08 | Professional | None | $489.78 | $575.44 | $676.08 |
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 $288.40 Median $549.54 Typical High $1,096.48 | Professional | None | $288.40 | $549.54 | $1,096.48 |
Health New England Setting Facility Modifier None Typical Low $199.53 Median $398.11 Typical High $3,090.30 | Facility | None | $199.53 | $398.11 | $3,090.30 |
Health New England Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $316.23 | Professional | None | $309.03 | $309.03 | $316.23 |
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 $269.15 Median $575.44 Typical High $2,884.03 | Professional | None | $269.15 | $575.44 | $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 $281.84 Median $501.19 Typical High $1,096.48 | Professional | None | $281.84 | $501.19 | $1,096.48 |
Well Sense Setting Facility Modifier None Typical Low $138.04 Median $269.15 Typical High $457.09 | Facility | None | $138.04 | $269.15 | $457.09 |
Well Sense Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $309.03 | Professional | None | $199.53 | $239.88 | $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 $93.33 Median $147.91 Typical High $363.08 | Professional | 52 · Reduced service | $93.33 | $147.91 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $58.88 Typical High $144.54 | Professional | 53 · Discontinued | $38.02 | $58.88 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $223.87 Typical High $537.03 | Professional | 54 · Surgery only | $141.25 | $223.87 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $44.67 Typical High $107.15 | Professional | 55 · Aftercare only | $28.18 | $44.67 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $29.51 Typical High $72.44 | Professional | 56 · Pre-op care only | $18.62 | $29.51 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $208.93 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $131.83 | $208.93 | $501.19 |
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· 7th of 51
$525
AK $977MD $282
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.