How much rates vary
Facilitymedian $407 · 10th to 90th $93 to $2,239Professionalmedian $501 · 10th to 90th $288 to $1,318
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 $741.31 Median $2,187.76 Typical High $3,630.78 | Facility | None | $741.31 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $758.58 | Professional | None | $263.03 | $288.40 | $758.58 |
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 $288.40 Median $602.56 Typical High $2,570.40 | Professional | None | $288.40 | $602.56 | $2,570.40 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $776.25 | Facility | None | $338.84 | $407.38 | $776.25 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $776.25 | Professional | None | $338.84 | $407.38 | $776.25 |
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 $407.38 Median $436.52 Typical High $794.33 | Professional | None | $407.38 | $436.52 | $794.33 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $407.38 Typical High $3,311.31 | Facility | None | $177.83 | $407.38 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $602.56 | Professional | None | $446.68 | $512.86 | $602.56 |
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 $354.81 Median $660.69 Typical High $1,000.00 | Professional | None | $354.81 | $660.69 | $1,000.00 |
Health New England Setting Facility Modifier None Typical Low $234.42 Median $239.88 Typical High $602.56 | Facility | None | $234.42 | $239.88 | $602.56 |
Health New England Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
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 $288.40 Median $602.56 Typical High $2,570.40 | Professional | None | $288.40 | $602.56 | $2,570.40 |
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 $309.03 Median $457.09 Typical High $1,318.26 | Professional | None | $309.03 | $457.09 | $1,318.26 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $288.40 Typical High $512.86 | Facility | None | $93.33 | $288.40 | $512.86 |
Well Sense Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $257.04 | Professional | None | $190.55 | $208.93 | $257.04 |
10 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 $131.83 Median $144.54 Typical High $371.54 | Professional | 52 · Reduced service | $131.83 | $144.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $57.54 Typical High $147.91 | Professional | 53 · Discontinued | $52.48 | $57.54 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $549.54 | Professional | 54 · Surgery only | $194.98 | $213.80 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $43.65 Typical High $109.65 | Professional | 55 · Aftercare only | $39.81 | $43.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $74.13 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $512.86 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $407.38 Typical High $1,412.54 | Professional | 54 · Surgery only | $234.42 | $407.38 | $1,412.54 |
BCBS Massachusetts Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $138.04 Typical High $186.21 | Professional | 55 · Aftercare only | $81.28 | $138.04 | $186.21 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $549.54 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $323.59 | $549.54 | $741.31 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $134.90 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $123.03 | $134.90 | $181.97 |
Where Massachusetts sits
The same service costs 5.8 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
$501
AK $1,202TX $209
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.