How much rates vary
Facilitymedian $66 · 10th to 90th $2 to $2,692Professionalmedian $8 · 10th to 90th $2 to $21
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 $20.42 Median $2,187.76 Typical High $3,630.78 | Facility | None | $20.42 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $4.37 Typical High $12.02 | Professional | None | $1.74 | $4.37 | $12.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $117.49 Median $549.54 Typical High $2,818.38 | Facility | None | $117.49 | $549.54 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.51 Median $8.13 Typical High $186.21 | Professional | None | $2.51 | $8.13 | $186.21 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $4.37 | Facility | None | $1.86 | $1.86 | $4.37 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1.86 Median $7.59 Typical High $13.18 | Professional | None | $1.86 | $7.59 | $13.18 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $199.53 Typical High $831.76 | Facility | None | $50.12 | $199.53 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $7.76 Typical High $15.49 | Professional | None | $2.19 | $7.76 | $15.49 |
Fallon Health Setting Facility Modifier None Typical Low $2.04 Median $2.51 Typical High $3,311.31 | Facility | None | $2.04 | $2.51 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $8.13 Median $9.55 Typical High $11.48 | Professional | None | $8.13 | $9.55 | $11.48 |
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 $2.69 Median $7.24 Typical High $18.20 | Professional | None | $2.69 | $7.24 | $18.20 |
Health New England Setting Facility Modifier None Typical Low $165.96 Median $275.42 Typical High $912.01 | Facility | None | $165.96 | $275.42 | $912.01 |
Health New England Setting Professional Modifier None Typical Low $9.12 Median $31.62 Typical High $112.20 | Professional | None | $9.12 | $31.62 | $112.20 |
Mass General Brigham Setting Facility Modifier None Typical Low $117.49 Median $549.54 Typical High $2,818.38 | Facility | None | $117.49 | $549.54 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.51 Median $8.13 Typical High $186.21 | Professional | None | $2.51 | $8.13 | $186.21 |
Tufts Setting Professional Modifier None Typical Low $5.50 Median $7.41 Typical High $13.18 | Professional | None | $5.50 | $7.41 | $13.18 |
United Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $2,818.38 | Facility | None | $117.49 | $537.03 | $2,818.38 |
United Setting Professional Modifier None Typical Low $2.82 Median $7.76 Typical High $19.50 | Professional | None | $2.82 | $7.76 | $19.50 |
Well Sense Setting Facility Modifier None Typical Low $1.86 Median $3.55 Typical High $9.12 | Facility | None | $1.86 | $3.55 | $9.12 |
Well Sense Setting Professional Modifier None Typical Low $3.24 Median $3.89 Typical High $6.46 | Professional | None | $3.24 | $3.89 | $6.46 |
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 $0.87 Median $2.19 Typical High $6.03 | Professional | 52 · Reduced service | $0.87 | $2.19 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.87 Typical High $2.40 | Professional | 53 · Discontinued | $0.35 | $0.87 | $2.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.32 Median $3.31 Typical High $9.12 | Professional | 54 · Surgery only | $1.32 | $3.31 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.66 Typical High $1.82 | Professional | 55 · Aftercare only | $0.26 | $0.66 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.44 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.18 | $0.44 | $1.20 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $3.24 Typical High $4.37 | Professional | 53 · Discontinued | $1.91 | $3.24 | $4.37 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6.17 Median $10.47 Typical High $14.13 | Professional | 78 · Unplanned return to OR | $6.17 | $10.47 | $14.13 |
Where Massachusetts sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 13th of 51
$7.59
AK $12.88NE $4.37
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.