How much rates vary
Facilitymedian $417 · 10th to 90th $166 to $3,311Professionalmedian $363 · 10th to 90th $178 to $977
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $467.74 | Professional | None | $158.49 | $245.47 | $467.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,096.48 Typical High $3,311.31 | Facility | None | $323.59 | $1,096.48 | $3,311.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $181.97 Median $416.87 Typical High $1,949.84 | Professional | None | $181.97 | $416.87 | $1,949.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $169.82 Median $204.17 Typical High $389.05 | Facility | None | $169.82 | $204.17 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $346.74 Typical High $489.78 | Facility | None | $199.53 | $346.74 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $354.81 Typical High $630.96 | Professional | None | $218.78 | $354.81 | $630.96 |
Fallon Health Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $3,311.31 | Facility | None | $165.96 | $223.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $457.09 | Professional | None | $346.74 | $398.11 | $457.09 |
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 $199.53 Median $389.05 Typical High $741.31 | Professional | None | $199.53 | $389.05 | $741.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,096.48 Typical High $3,311.31 | Facility | None | $323.59 | $1,096.48 | $3,311.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $181.97 Median $416.87 Typical High $1,949.84 | Professional | None | $181.97 | $416.87 | $1,949.84 |
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 $199.53 Median $346.74 Typical High $758.58 | Professional | None | $199.53 | $346.74 | $758.58 |
Well Sense Setting Facility Modifier None Typical Low $134.90 Median $199.53 Typical High $309.03 | Facility | None | $134.90 | $199.53 | $309.03 |
Well Sense Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $218.78 | Professional | None | $120.23 | $162.18 | $218.78 |
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 $77.62 Median $123.03 Typical High $234.42 | Professional | 52 · Reduced service | $77.62 | $123.03 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $48.98 Typical High $93.33 | Professional | 53 · Discontinued | $31.62 | $48.98 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $181.97 Typical High $354.81 | Professional | 54 · Surgery only | $117.49 | $181.97 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $37.15 Typical High $70.79 | Professional | 55 · Aftercare only | $23.44 | $37.15 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $24.55 Typical High $46.77 | Professional | 56 · Pre-op care only | $15.85 | $24.55 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $169.82 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $109.65 | $169.82 | $331.13 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $114.82 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $77.62 | $114.82 | $158.49 |
Where Massachusetts sits
The same service costs 3.7 times more in Alaska than in Utah. 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
$363
AK $692UT $186
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.