How much rates vary
Facilitymedian $1,660 · 10th to 90th $676 to $5,754Professionalmedian $1,122 · 10th to 90th $589 to $6,310
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 $1,905.46 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,905.46 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,548.82 | Professional | None | $512.86 | $512.86 | $1,548.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $5,888.44 | Facility | None | $645.65 | $2,089.30 | $5,888.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $676.08 Median $1,862.09 Typical High $6,309.57 | Professional | None | $676.08 | $1,862.09 | $6,309.57 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $691.83 Median $1,202.26 Typical High $1,584.89 | Professional | None | $691.83 | $1,202.26 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,137.96 Typical High $3,090.30 | Facility | None | $831.76 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,096.48 | $2,137.96 |
Fallon Health Setting Facility Modifier None Typical Low $691.83 Median $870.96 Typical High $3,311.31 | Facility | None | $691.83 | $870.96 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,071.52 | Professional | None | $741.31 | $870.96 | $1,071.52 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $741.31 Median $1,348.96 Typical High $2,344.23 | Professional | None | $741.31 | $1,348.96 | $2,344.23 |
Health New England Setting Facility Modifier None Typical Low $851.14 Median $5,128.61 Typical High $18,620.87 | Facility | None | $851.14 | $5,128.61 | $18,620.87 |
Health New England Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Mass General Brigham Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $5,888.44 | Facility | None | $645.65 | $2,089.30 | $5,888.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $676.08 Median $1,862.09 Typical High $6,309.57 | Professional | None | $676.08 | $1,862.09 | $6,309.57 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $10,471.29 | Facility | None | $851.14 | $2,818.38 | $10,471.29 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $2,344.23 | Professional | None | $724.44 | $1,023.29 | $2,344.23 |
Well Sense Setting Facility Modifier None Typical Low $562.34 Median $891.25 Typical High $1,148.15 | Facility | None | $562.34 | $891.25 | $1,148.15 |
Well Sense Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | None | $489.78 | $489.78 | $588.84 |
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 $257.04 Median $257.04 Typical High $954.99 | Professional | 52 · Reduced service | $257.04 | $257.04 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $380.19 | Professional | 53 · Discontinued | $102.33 | $102.33 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $1,412.54 | Professional | 54 · Surgery only | $389.05 | $389.05 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $281.84 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $190.55 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $1,318.26 |
Where Massachusetts sits
The same service costs 3.9 times more in Connecticut than in Montana. 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.
Physician feeFacility fee
CT $8,362MT $2,119
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.