How much rates vary
Facilitymedian $1,549 · 10th to 90th $646 to $6,166Professionalmedian $1,202 · 10th to 90th $676 to $2,951
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 $1,778.28 Median $2,818.38 Typical High $5,248.07 | Facility | None | $1,778.28 | $2,818.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,778.28 | Professional | None | $602.56 | $758.58 | $1,778.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $645.65 Median $3,090.30 Typical High $9,549.93 | Facility | None | $645.65 | $3,090.30 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $645.65 Median $1,318.26 Typical High $5,623.41 | Professional | None | $645.65 | $1,318.26 | $5,623.41 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $660.69 Median $794.33 Typical High $1,513.56 | Facility | None | $660.69 | $794.33 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,890.45 Typical High $5,754.40 | Facility | None | $831.76 | $3,890.45 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $2,041.74 | Professional | None | $851.14 | $1,047.13 | $2,041.74 |
Fallon Health Setting Facility Modifier None Typical Low $645.65 Median $851.14 Typical High $3,311.31 | Facility | None | $645.65 | $851.14 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,318.26 | Professional | None | $977.24 | $1,148.15 | $1,318.26 |
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 $691.83 Median $1,380.38 Typical High $2,290.87 | Professional | None | $691.83 | $1,380.38 | $2,290.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $645.65 Median $3,090.30 Typical High $9,549.93 | Facility | None | $645.65 | $3,090.30 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $645.65 Median $1,318.26 Typical High $5,623.41 | Professional | None | $645.65 | $1,318.26 | $5,623.41 |
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 $724.44 Median $1,096.48 Typical High $2,884.03 | Professional | None | $724.44 | $1,096.48 | $2,884.03 |
Well Sense Setting Facility Modifier None Typical Low $588.84 Median $812.83 Typical High $1,905.46 | Facility | None | $588.84 | $812.83 | $1,905.46 |
Well Sense Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $660.69 | Professional | None | $446.68 | $549.54 | $660.69 |
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 $302.00 Median $380.19 Typical High $891.25 | Professional | 52 · Reduced service | $302.00 | $380.19 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $151.36 Typical High $354.81 | Professional | 53 · Discontinued | $120.23 | $151.36 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $1,318.26 | Professional | 54 · Surgery only | $457.09 | $562.34 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $112.20 Typical High $263.03 | Professional | 55 · Aftercare only | $91.20 | $112.20 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $75.86 Typical High $177.83 | Professional | 56 · Pre-op care only | $60.26 | $75.86 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $524.81 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $426.58 | $524.81 | $1,230.27 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $354.81 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $288.40 | $354.81 | $478.63 |
Where Massachusetts sits
The same service costs 6.6 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
$1,202
AK $3,020TX $457
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.