How much rates vary
Facilitymedian $501 · 10th to 90th $162 to $3,311Professionalmedian $447 · 10th to 90th $162 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 $426.58 Median $2,137.96 Typical High $3,630.78 | Facility | None | $426.58 | $2,137.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $371.54 Typical High $575.44 | Professional | None | $138.04 | $371.54 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $263.03 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $97.72 | $263.03 | $302.00 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $1,071.52 Typical High $3,311.31 | Facility | None | $354.81 | $1,071.52 | $3,311.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $169.82 Median $489.78 Typical High $2,884.03 | Professional | None | $169.82 | $489.78 | $2,884.03 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $162.18 Median $194.98 Typical High $371.54 | Facility | None | $162.18 | $194.98 | $371.54 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $162.18 Median $446.68 Typical High $758.58 | Professional | None | $162.18 | $446.68 | $758.58 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $218.78 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $128.82 | $218.78 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,445.44 | Facility | None | $446.68 | $977.24 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $489.78 Typical High $891.25 | Professional | None | $194.98 | $489.78 | $891.25 |
Fallon Health Setting Facility Modifier None Typical Low $158.49 Median $208.93 Typical High $3,311.31 | Facility | None | $158.49 | $208.93 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $660.69 | Professional | None | $489.78 | $575.44 | $660.69 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $186.21 Median $446.68 Typical High $1,047.13 | Professional | None | $186.21 | $446.68 | $1,047.13 |
Health New England Setting Facility Modifier None Typical Low $1,047.13 Median $1,819.70 Typical High $1,949.84 | Facility | None | $1,047.13 | $1,819.70 | $1,949.84 |
Health New England Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $660.69 | Professional | None | $229.09 | $302.00 | $660.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $1,071.52 Typical High $3,311.31 | Facility | None | $354.81 | $1,071.52 | $3,311.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $169.82 Median $489.78 Typical High $2,884.03 | Professional | None | $169.82 | $489.78 | $2,884.03 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,456.54 | Facility | None | $575.44 | $1,380.38 | $6,456.54 |
United Setting Professional Modifier None Typical Low $190.55 Median $501.19 Typical High $1,071.52 | Professional | None | $190.55 | $501.19 | $1,071.52 |
Well Sense Setting Facility Modifier None Typical Low $131.83 Median $309.03 Typical High $562.34 | Facility | None | $131.83 | $309.03 | $562.34 |
Well Sense Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $346.74 | Professional | None | $107.15 | $144.54 | $346.74 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $102.33 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $69.18 | $102.33 | $251.19 |
5 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 $69.18 Median $186.21 Typical High $218.78 | Professional | 52 · Reduced service | $69.18 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $74.13 Typical High $87.10 | Professional | 53 · Discontinued | $27.54 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $281.84 Typical High $323.59 | Professional | 54 · Surgery only | $104.71 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $56.23 Typical High $64.57 | Professional | 55 · Aftercare only | $20.89 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $37.15 Typical High $43.65 | Professional | 56 · Pre-op care only | $13.80 | $37.15 | $43.65 |
Where Massachusetts sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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
$447
AK $759KY $191
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.