How much rates vary
Facilitymedian $380 · 10th to 90th $98 to $2,239Professionalmedian $479 · 10th to 90th $263 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 $501.19 Median $2,137.96 Typical High $3,630.78 | Facility | None | $501.19 | $2,137.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $645.65 | Professional | None | $234.42 | $263.03 | $645.65 |
AllWays Health Partners Setting Facility Modifier None Typical Low $93.33 Median $467.74 Typical High $1,862.09 | Facility | None | $93.33 | $467.74 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $263.03 Median $562.34 Typical High $2,454.71 | Professional | None | $263.03 | $562.34 | $2,454.71 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $323.59 Median $389.05 Typical High $724.44 | Facility | None | $323.59 | $389.05 | $724.44 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $724.44 | Professional | None | $323.59 | $389.05 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $181.97 Typical High $263.03 | Facility | None | $53.70 | $181.97 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $741.31 | Professional | None | $371.54 | $416.87 | $741.31 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $380.19 Typical High $3,311.31 | Facility | None | $177.83 | $380.19 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $575.44 | Professional | None | $436.52 | $501.19 | $575.44 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $331.13 Median $616.60 Typical High $954.99 | Professional | None | $331.13 | $616.60 | $954.99 |
Health New England Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $575.44 | Facility | None | $562.34 | $562.34 | $575.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $93.33 Median $467.74 Typical High $1,862.09 | Facility | None | $93.33 | $467.74 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $263.03 Median $562.34 Typical High $2,454.71 | Professional | None | $263.03 | $562.34 | $2,454.71 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $1,174.90 | Professional | None | $269.15 | $416.87 | $1,174.90 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $269.15 Typical High $478.63 | Facility | None | $93.33 | $269.15 | $478.63 |
Well Sense Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $223.87 | Professional | None | $165.96 | $186.21 | $223.87 |
8 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 $117.49 Median $131.83 Typical High $316.23 | Professional | 52 · Reduced service | $117.49 | $131.83 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $52.48 Typical High $128.82 | Professional | 53 · Discontinued | $46.77 | $52.48 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $199.53 Typical High $478.63 | Professional | 54 · Surgery only | $177.83 | $199.53 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $39.81 Typical High $95.50 | Professional | 55 · Aftercare only | $35.48 | $39.81 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $26.30 Typical High $64.57 | Professional | 56 · Pre-op care only | $23.44 | $26.30 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $186.21 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $165.96 | $186.21 | $446.68 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $323.59 Typical High $501.19 | Professional | 54 · Surgery only | $213.80 | $323.59 | $501.19 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $120.23 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $107.15 | $120.23 | $162.18 |
Where Massachusetts sits
The same service costs 5.4 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
$468
AK $1,096TX $204
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.