How much rates vary
Facilitymedian $1,175 · 10th to 90th $589 to $3,548Professionalmedian $1,514 · 10th to 90th $776 to $3,162
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $2,238.72 | Professional | None | $645.65 | $776.25 | $2,238.72 |
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 $776.25 Median $1,949.84 Typical High $7,413.10 | Professional | None | $776.25 | $1,949.84 | $7,413.10 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,905.46 | Facility | None | $831.76 | $1,000.00 | $1,905.46 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $831.76 Median $1,412.54 Typical High $2,089.30 | Professional | None | $831.76 | $1,412.54 | $2,089.30 |
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 $954.99 Median $1,174.90 Typical High $2,454.71 | Professional | None | $954.99 | $1,174.90 | $2,454.71 |
Fallon Health Setting Facility Modifier None Typical Low $758.58 Median $1,047.13 Typical High $3,311.31 | Facility | None | $758.58 | $1,047.13 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,479.11 | $1,737.80 |
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 $870.96 Median $1,862.09 Typical High $2,951.21 | Professional | None | $870.96 | $1,862.09 | $2,951.21 |
Health New England Setting Facility Modifier None Typical Low $102.33 Median $2,951.21 Typical High $3,388.44 | Facility | None | $102.33 | $2,951.21 | $3,388.44 |
Health New England Setting Professional Modifier None Typical Low $1,584.89 Median $1,621.81 Typical High $1,737.80 | Professional | None | $1,584.89 | $1,621.81 | $1,737.80 |
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 $776.25 Median $1,949.84 Typical High $7,413.10 | Professional | None | $776.25 | $1,949.84 | $7,413.10 |
Tufts Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,905.46 | Professional | None | $794.33 | $1,148.15 | $1,905.46 |
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 $776.25 Median $1,348.96 Typical High $2,951.21 | Professional | None | $776.25 | $1,348.96 | $2,951.21 |
Well Sense Setting Facility Modifier None Typical Low $691.83 Median $891.25 Typical High $1,479.11 | Facility | None | $691.83 | $891.25 | $1,479.11 |
Well Sense Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $870.96 | Professional | None | $630.96 | $724.44 | $870.96 |
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 $323.59 Median $389.05 Typical High $1,122.02 | Professional | 52 · Reduced service | $323.59 | $389.05 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $154.88 Typical High $446.68 | Professional | 53 · Discontinued | $128.82 | $154.88 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $575.44 Typical High $1,659.59 | Professional | 54 · Surgery only | $489.78 | $575.44 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $114.82 Typical High $331.13 | Professional | 55 · Aftercare only | $97.72 | $114.82 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $77.62 Typical High $223.87 | Professional | 56 · Pre-op care only | $64.57 | $77.62 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $537.03 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $457.09 | $537.03 | $1,548.82 |
Where Massachusetts sits
The same service costs 4.4 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· 11th of 51
$1,445
AK $3,311TX $759
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.