How much rates vary
Facilitymedian $123 · 10th to 90th $52 to $2,138Professionalmedian $112 · 10th to 90th $60 to $275
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 $181.97 Median $2,187.76 Typical High $3,630.78 | Facility | None | $181.97 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $162.18 | Professional | None | $52.48 | $72.44 | $162.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $309.03 Typical High $1,862.09 | Facility | None | $50.12 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $63.10 Median $131.83 Typical High $645.65 | Professional | None | $63.10 | $131.83 | $645.65 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $128.82 | Facility | None | $54.95 | $54.95 | $128.82 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $54.95 Median $102.33 Typical High $177.83 | Professional | None | $54.95 | $102.33 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $100.00 Typical High $489.78 | Facility | None | $77.62 | $100.00 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $199.53 | Professional | None | $74.13 | $112.20 | $199.53 |
Fallon Health Setting Facility Modifier None Typical Low $54.95 Median $70.79 Typical High $3,311.31 | Facility | None | $54.95 | $70.79 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $151.36 | Professional | None | $112.20 | $131.83 | $151.36 |
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 $69.18 Median $128.82 Typical High $251.19 | Professional | None | $69.18 | $128.82 | $251.19 |
Health New England Setting Facility Modifier None Typical Low $346.74 Median $446.68 Typical High $660.69 | Facility | None | $346.74 | $446.68 | $660.69 |
Health New England Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $218.78 | Professional | None | $109.65 | $141.25 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $309.03 Typical High $1,862.09 | Facility | None | $50.12 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $63.10 Median $131.83 Typical High $645.65 | Professional | None | $63.10 | $131.83 | $645.65 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $257.04 | Professional | None | $70.79 | $107.15 | $257.04 |
Well Sense Setting Facility Modifier None Typical Low $35.48 Median $63.10 Typical High $97.72 | Facility | None | $35.48 | $63.10 | $97.72 |
Well Sense Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $64.57 | Professional | None | $40.74 | $53.70 | $64.57 |
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 $26.30 Median $35.48 Typical High $81.28 | Professional | 52 · Reduced service | $26.30 | $35.48 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $14.45 Typical High $32.36 | Professional | 53 · Discontinued | $10.47 | $14.45 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $53.70 Typical High $123.03 | Professional | 54 · Surgery only | $38.90 | $53.70 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.72 Typical High $24.55 | Professional | 55 · Aftercare only | $7.94 | $10.72 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.24 Typical High $16.22 | Professional | 56 · Pre-op care only | $5.25 | $7.24 | $16.22 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $43.65 Median $81.28 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $43.65 | $81.28 | $151.36 |
Where Massachusetts sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 12th of 51
$112
AK $229FL $67.61
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.