How much rates vary
Facilitymedian $145 · 10th to 90th $78 to $2,344Professionalmedian $219 · 10th to 90th $83 to $562
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 $131.83 Median $1,479.11 Typical High $3,388.44 | Facility | None | $131.83 | $1,479.11 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $154.88 Typical High $295.12 | Professional | None | $77.62 | $154.88 | $295.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $61.66 Median $218.78 Typical High $1,819.70 | Facility | None | $61.66 | $218.78 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $83.18 Median $239.88 Typical High $2,344.23 | Professional | None | $83.18 | $239.88 | $2,344.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $194.98 | Facility | None | $83.18 | $83.18 | $194.98 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $83.18 Median $208.93 Typical High $354.81 | Professional | None | $83.18 | $208.93 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $53.70 Typical High $831.76 | Facility | None | $50.12 | $53.70 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $223.87 Typical High $407.38 | Professional | None | $107.15 | $223.87 | $407.38 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $104.71 Typical High $3,311.31 | Facility | None | $83.18 | $104.71 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $309.03 | Professional | None | $229.09 | $269.15 | $309.03 |
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 $89.13 Median $213.80 Typical High $489.78 | Professional | None | $89.13 | $213.80 | $489.78 |
Health New England Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $2,951.21 | Facility | None | $691.83 | $1,445.44 | $2,951.21 |
Health New England Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $457.09 | Professional | None | $169.82 | $302.00 | $457.09 |
Mass General Brigham Setting Facility Modifier None Typical Low $61.66 Median $218.78 Typical High $1,819.70 | Facility | None | $61.66 | $218.78 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $83.18 Median $239.88 Typical High $2,344.23 | Professional | None | $83.18 | $239.88 | $2,344.23 |
United Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $2,818.38 | Facility | None | $117.49 | $537.03 | $2,818.38 |
United Setting Professional Modifier None Typical Low $91.20 Median $229.09 Typical High $524.81 | Professional | None | $91.20 | $229.09 | $524.81 |
Well Sense Setting Facility Modifier None Typical Low $72.44 Median $125.89 Typical High $204.17 | Facility | None | $72.44 | $125.89 | $204.17 |
Well Sense Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $162.18 | Professional | None | $50.12 | $67.61 | $162.18 |
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 $38.90 Median $77.62 Typical High $100.00 | Professional | 52 · Reduced service | $38.90 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $30.90 Typical High $39.81 | Professional | 53 · Discontinued | $15.49 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $114.82 Typical High $151.36 | Professional | 54 · Surgery only | $58.88 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $22.91 Typical High $30.20 | Professional | 55 · Aftercare only | $11.75 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $15.49 Typical High $19.95 | Professional | 56 · Pre-op care only | $7.76 | $15.49 | $19.95 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $35.48 Typical High $61.66 | Professional | 53 · Discontinued | $26.92 | $35.48 | $61.66 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $32.36 Median $48.98 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $32.36 | $48.98 | $117.49 |
Where Massachusetts sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 12th of 51
$214
AK $417VA $107
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.