How much rates vary
Facilitymedian $912 · 10th to 90th $550 to $3,548Professionalmedian $1,148 · 10th to 90th $589 to $2,570
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 $812.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $812.83 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,621.81 | Professional | None | $467.74 | $588.84 | $1,621.81 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $1,258.93 Typical High $3,715.35 | Facility | None | $457.09 | $1,258.93 | $3,715.35 |
AllWays Health Partners Setting Professional Modifier None Typical Low $588.84 Median $1,445.44 Typical High $5,888.44 | Professional | None | $588.84 | $1,445.44 | $5,888.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $616.60 Median $741.31 Typical High $1,412.54 | Facility | None | $616.60 | $741.31 | $1,412.54 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $616.60 Median $1,047.13 Typical High $1,659.59 | Professional | None | $616.60 | $1,047.13 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,513.56 Typical High $2,187.76 | Facility | None | $588.84 | $1,513.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,905.46 | Professional | None | $691.83 | $912.01 | $1,905.46 |
Fallon Health Setting Facility Modifier None Typical Low $602.56 Median $776.25 Typical High $3,311.31 | Facility | None | $602.56 | $776.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,174.90 | $1,380.38 |
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 $676.08 Median $1,380.38 Typical High $2,238.72 | Professional | None | $676.08 | $1,380.38 | $2,238.72 |
Health New England Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $1,258.93 Typical High $3,715.35 | Facility | None | $457.09 | $1,258.93 | $3,715.35 |
Mass General Brigham Setting Professional Modifier None Typical Low $588.84 Median $1,445.44 Typical High $5,888.44 | Professional | None | $588.84 | $1,445.44 | $5,888.44 |
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 $660.69 Median $1,047.13 Typical High $2,187.76 | Professional | None | $660.69 | $1,047.13 | $2,187.76 |
Well Sense Setting Facility Modifier None Typical Low $501.19 Median $691.83 Typical High $1,071.52 | Facility | None | $501.19 | $691.83 | $1,071.52 |
Well Sense Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $660.69 | Professional | None | $446.68 | $537.03 | $660.69 |
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 $234.42 Median $295.12 Typical High $812.83 | Professional | 52 · Reduced service | $234.42 | $295.12 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $117.49 Typical High $323.59 | Professional | 53 · Discontinued | $93.33 | $117.49 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $446.68 Typical High $1,202.26 | Professional | 54 · Surgery only | $346.74 | $446.68 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $89.13 Typical High $239.88 | Professional | 55 · Aftercare only | $69.18 | $89.13 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $58.88 Typical High $162.18 | Professional | 56 · Pre-op care only | $46.77 | $58.88 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $416.87 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $323.59 | $416.87 | $1,122.02 |
Where Massachusetts sits
The same service costs 4.2 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
$1,122
AK $2,455TX $589
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.