How much rates vary
Facilitymedian $468 · 10th to 90th $251 to $2,951Professionalmedian $537 · 10th to 90th $295 to $1,202
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $389.05 | Professional | None | $245.47 | $331.13 | $389.05 |
AllWays Health Partners Setting Facility Modifier None Typical Low $275.42 Median $851.14 Typical High $2,884.03 | Facility | None | $275.42 | $851.14 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $288.40 Median $630.96 Typical High $2,951.21 | Professional | None | $288.40 | $630.96 | $2,951.21 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $660.69 | Facility | None | $288.40 | $288.40 | $660.69 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $812.83 | Professional | None | $467.74 | $512.86 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $501.19 Typical High $676.08 | Facility | None | $66.07 | $501.19 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $954.99 | Professional | None | $354.81 | $512.86 | $954.99 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $3,311.31 | Facility | None | $177.83 | $346.74 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $691.83 | Professional | None | $512.86 | $602.56 | $691.83 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $309.03 Median $616.60 Typical High $1,148.15 | Professional | None | $309.03 | $616.60 | $1,148.15 |
Health New England Setting Facility Modifier None Typical Low $302.00 Median $2,818.38 Typical High $4,466.84 | Facility | None | $302.00 | $2,818.38 | $4,466.84 |
Health New England Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $275.42 Median $851.14 Typical High $2,884.03 | Facility | None | $275.42 | $851.14 | $2,884.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $288.40 Median $630.96 Typical High $2,951.21 | Professional | None | $288.40 | $630.96 | $2,951.21 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $5,370.32 | Facility | None | $407.38 | $870.96 | $5,370.32 |
United Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $1,174.90 | Professional | None | $316.23 | $501.19 | $1,174.90 |
Well Sense Setting Facility Modifier None Typical Low $208.93 Median $302.00 Typical High $467.74 | Facility | None | $208.93 | $302.00 | $467.74 |
Well Sense Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $288.40 | Professional | None | $186.21 | $239.88 | $288.40 |
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 $120.23 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $120.23 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $48.98 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $181.97 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $36.31 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $24.55 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $169.82 | $234.42 | $234.42 |
Where Massachusetts sits
The same service costs 4.5 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· 9th of 51
$525
AK $1,072TX $240
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.