How much rates vary
Facilitymedian $1,479 · 10th to 90th $631 to $6,166Professionalmedian $1,230 · 10th to 90th $676 to $2,818
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 $1,819.70 Median $3,090.30 Typical High $6,309.57 | Facility | None | $1,819.70 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,819.70 | Professional | None | $575.44 | $776.25 | $1,819.70 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $9,549.93 | Facility | None | $724.44 | $3,090.30 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $707.95 Median $1,348.96 Typical High $10,000.00 | Professional | None | $707.95 | $1,348.96 | $10,000.00 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $630.96 Median $776.25 Typical High $1,445.44 | Facility | None | $630.96 | $776.25 | $1,445.44 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,862.09 | Professional | None | $954.99 | $1,096.48 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,890.45 Typical High $5,754.40 | Facility | None | $954.99 | $3,890.45 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $2,041.74 | Professional | None | $812.83 | $1,071.52 | $2,041.74 |
Fallon Health Setting Facility Modifier None Typical Low $630.96 Median $812.83 Typical High $3,311.31 | Facility | None | $630.96 | $812.83 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,202.26 | $1,412.54 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $724.44 Median $1,348.96 Typical High $2,398.83 | Professional | None | $724.44 | $1,348.96 | $2,398.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $9,549.93 | Facility | None | $724.44 | $3,090.30 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $707.95 Median $1,348.96 Typical High $10,000.00 | Professional | None | $707.95 | $1,348.96 | $10,000.00 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $13,489.63 | Facility | None | $1,071.52 | $3,467.37 | $13,489.63 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $2,754.23 | Professional | None | $741.31 | $1,122.02 | $2,754.23 |
Well Sense Setting Facility Modifier None Typical Low $562.34 Median $870.96 Typical High $1,905.46 | Facility | None | $562.34 | $870.96 | $1,905.46 |
Well Sense Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $758.58 | Professional | None | $478.63 | $630.96 | $758.58 |
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 $288.40 Median $389.05 Typical High $912.01 | Professional | 52 · Reduced service | $288.40 | $389.05 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $154.88 Typical High $363.08 | Professional | 53 · Discontinued | $114.82 | $154.88 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $588.84 Typical High $1,348.96 | Professional | 54 · Surgery only | $436.52 | $588.84 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $117.49 Typical High $275.42 | Professional | 55 · Aftercare only | $87.10 | $117.49 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $77.62 Typical High $181.97 | Professional | 56 · Pre-op care only | $57.54 | $77.62 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $549.54 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $407.38 | $549.54 | $1,258.93 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $398.11 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $309.03 | $398.11 | $537.03 |
Where Massachusetts sits
The same service costs 6.2 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· 10th of 51
$1,230
AK $3,020TX $490
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.