How much rates vary
Facilitymedian $871 · 10th to 90th $525 to $3,631Professionalmedian $1,047 · 10th to 90th $537 to $2,344
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 $2,691.53 Typical High $4,677.35 | Facility | None | $1,023.29 | $2,691.53 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $1,479.11 | Professional | None | $436.52 | $537.03 | $1,479.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
AllWays Health Partners Setting Professional Modifier None Typical Low $562.34 Median $1,348.96 Typical High $5,370.32 | Professional | None | $562.34 | $1,348.96 | $5,370.32 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $575.44 Median $691.83 Typical High $1,318.26 | Facility | None | $575.44 | $691.83 | $1,318.26 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $575.44 Median $977.24 Typical High $1,513.56 | Professional | None | $575.44 | $977.24 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $2,187.76 | Facility | None | $676.08 | $1,513.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,737.80 | Professional | None | $645.65 | $831.76 | $1,737.80 |
Fallon Health Setting Facility Modifier None Typical Low $562.34 Median $741.31 Typical High $3,311.31 | Facility | None | $562.34 | $741.31 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,258.93 | Professional | None | $912.01 | $1,071.52 | $1,258.93 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,041.74 | Professional | None | $602.56 | $1,318.26 | $2,041.74 |
Health New England Setting Facility Modifier None Typical Low $165.96 Median $630.96 Typical High $4,786.30 | Facility | None | $165.96 | $630.96 | $4,786.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
Mass General Brigham Setting Professional Modifier None Typical Low $562.34 Median $1,348.96 Typical High $5,370.32 | Professional | None | $562.34 | $1,348.96 | $5,370.32 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,918.31 | Facility | None | $575.44 | $1,380.38 | $6,918.31 |
United Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $1,995.26 | Professional | None | $602.56 | $954.99 | $1,995.26 |
Well Sense Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $1,000.00 | Facility | None | $512.86 | $691.83 | $1,000.00 |
Well Sense Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $602.56 | Professional | None | $416.87 | $501.19 | $602.56 |
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 $213.80 Median $269.15 Typical High $741.31 | Professional | 52 · Reduced service | $213.80 | $269.15 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $107.15 Typical High $302.00 | Professional | 53 · Discontinued | $87.10 | $107.15 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $398.11 Typical High $1,122.02 | Professional | 54 · Surgery only | $323.59 | $398.11 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $79.43 Typical High $223.87 | Professional | 55 · Aftercare only | $64.57 | $79.43 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $53.70 Typical High $147.91 | Professional | 56 · Pre-op care only | $43.65 | $53.70 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $371.54 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $302.00 | $371.54 | $1,047.13 |
Where Massachusetts sits
The same service costs 4.3 times more in Alaska than in Texas. 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· 9th of 51
$1,047
AK $2,291TX $537
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.