How much rates vary
Facilitymedian $98 · 10th to 90th $36 to $2,042Professionalmedian $76 · 10th to 90th $40 to $174
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 $51.29 Median $1,819.70 Typical High $3,388.44 | Facility | None | $51.29 | $1,819.70 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $102.33 | Professional | None | $34.67 | $51.29 | $102.33 |
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 $40.74 Median $87.10 Typical High $645.65 | Professional | None | $40.74 | $87.10 | $645.65 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $91.20 | Facility | None | $39.81 | $39.81 | $91.20 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $104.71 | Professional | None | $39.81 | $60.26 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $60.26 Typical High $489.78 | Facility | None | $42.66 | $60.26 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $131.83 | Professional | None | $46.77 | $69.18 | $131.83 |
Fallon Health Setting Facility Modifier None Typical Low $39.81 Median $52.48 Typical High $3,311.31 | Facility | None | $39.81 | $52.48 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $66.07 Median $75.86 Typical High $89.13 | Professional | None | $66.07 | $75.86 | $89.13 |
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 $43.65 Median $89.13 Typical High $154.88 | Professional | None | $43.65 | $89.13 | $154.88 |
Health New England Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $524.81 | Facility | None | $208.93 | $346.74 | $524.81 |
Health New England Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $436.52 | Professional | None | $67.61 | $87.10 | $436.52 |
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 $40.74 Median $87.10 Typical High $645.65 | Professional | None | $40.74 | $87.10 | $645.65 |
Tufts Setting Facility Modifier None Typical Low $13.80 Median $426.58 Typical High $602.56 | Facility | None | $13.80 | $426.58 | $602.56 |
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 $43.65 Median $75.86 Typical High $173.78 | Professional | None | $43.65 | $75.86 | $173.78 |
Well Sense Setting Facility Modifier None Typical Low $25.70 Median $39.81 Typical High $63.10 | Facility | None | $25.70 | $39.81 | $63.10 |
Well Sense Setting Professional Modifier None Typical Low $26.30 Median $35.48 Typical High $45.71 | Professional | None | $26.30 | $35.48 | $45.71 |
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 $17.38 Median $25.70 Typical High $51.29 | Professional | 52 · Reduced service | $17.38 | $25.70 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $10.47 Typical High $20.42 | Professional | 53 · Discontinued | $6.92 | $10.47 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $38.90 Typical High $75.86 | Professional | 54 · Surgery only | $25.70 | $38.90 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $7.76 Typical High $15.14 | Professional | 55 · Aftercare only | $5.25 | $7.76 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.13 Typical High $10.23 | Professional | 56 · Pre-op care only | $3.47 | $5.13 | $10.23 |
BCBS Massachusetts Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $20.42 Typical High $32.36 | Professional | 55 · Aftercare only | $15.49 | $20.42 | $32.36 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $83.18 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $61.66 | $83.18 | $128.82 |
Where Massachusetts sits
The same service costs 4.2 times more in Alaska than in New York. 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· 10th of 51
$77.62
AK $186NY $44.67
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.