How much rates vary
Facilitymedian $372 · 10th to 90th $162 to $2,399Professionalmedian $513 · 10th to 90th $269 to $1,175
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 $741.31 Median $2,691.53 Typical High $3,715.35 | Facility | None | $741.31 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $741.31 | Professional | None | $208.93 | $269.15 | $741.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $162.18 Median $549.54 Typical High $1,862.09 | Facility | None | $162.18 | $549.54 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $269.15 Median $588.84 Typical High $2,630.27 | Professional | None | $269.15 | $588.84 | $2,630.27 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $575.44 | Facility | None | $251.19 | $251.19 | $575.44 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $724.44 | Professional | None | $251.19 | $426.58 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $257.04 Typical High $371.54 | Facility | None | $53.70 | $257.04 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $870.96 | Professional | None | $302.00 | $416.87 | $870.96 |
Fallon Health Setting Facility Modifier None Typical Low $251.19 Median $331.13 Typical High $3,311.31 | Facility | None | $251.19 | $331.13 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $616.60 | Professional | None | $446.68 | $524.81 | $616.60 |
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 $309.03 Median $588.84 Typical High $1,000.00 | Professional | None | $309.03 | $588.84 | $1,000.00 |
Health New England Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $162.18 Median $549.54 Typical High $1,862.09 | Facility | None | $162.18 | $549.54 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $269.15 Median $588.84 Typical High $2,630.27 | Professional | None | $269.15 | $588.84 | $2,630.27 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,818.38 | Facility | None | $123.03 | $549.54 | $2,818.38 |
United Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $977.24 | Professional | None | $302.00 | $467.74 | $977.24 |
Well Sense Setting Facility Modifier None Typical Low $162.18 Median $295.12 Typical High $467.74 | Facility | None | $162.18 | $295.12 | $467.74 |
Well Sense Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $316.23 | Professional | None | $208.93 | $251.19 | $316.23 |
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 $104.71 Median $134.90 Typical High $371.54 | Professional | 52 · Reduced service | $104.71 | $134.90 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $53.70 Typical High $147.91 | Professional | 53 · Discontinued | $41.69 | $53.70 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $204.17 Typical High $562.34 | Professional | 54 · Surgery only | $158.49 | $204.17 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $40.74 Typical High $112.20 | Professional | 55 · Aftercare only | $31.62 | $40.74 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.92 Typical High $74.13 | Professional | 56 · Pre-op care only | $20.89 | $26.92 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $190.55 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $147.91 | $190.55 | $524.81 |
Where Massachusetts sits
The same service costs 4.0 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· 8th of 51
$501
AK $1,096TX $275
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.