How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,000 to $8,318Professionalmedian $2,570 · 10th to 90th $1,585 to $10,965
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 $2,884.03 Typical High $4,677.35 | Facility | None | $1,778.28 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $4,677.35 | Professional | None | $1,513.56 | $1,513.56 | $4,677.35 |
AllWays Health Partners Setting Facility Modifier None Typical Low $707.95 Median $4,073.80 Typical High $12,022.64 | Facility | None | $707.95 | $4,073.80 | $12,022.64 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,737.80 Median $3,890.45 Typical High $10,964.78 | Professional | None | $1,737.80 | $3,890.45 | $10,964.78 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,630.78 | Professional | None | $1,659.59 | $1,659.59 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,165.95 Typical High $20,417.38 | Facility | None | $676.08 | $6,165.95 | $20,417.38 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $4,265.80 | Professional | None | $2,187.76 | $2,187.76 | $4,265.80 |
Fallon Health Setting Facility Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $3,630.78 | Facility | None | $1,584.89 | $2,041.74 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $2,454.71 | Professional | None | $1,862.09 | $2,137.96 | $2,454.71 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,819.70 Median $3,311.31 Typical High $5,011.87 | Professional | None | $1,819.70 | $3,311.31 | $5,011.87 |
Health New England Setting Facility Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $42,657.95 | Facility | None | $12,302.69 | $12,302.69 | $42,657.95 |
Health New England Setting Professional Modifier None Typical Low $1,819.70 Median $3,630.78 Typical High $3,630.78 | Professional | None | $1,819.70 | $3,630.78 | $3,630.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $707.95 Median $4,073.80 Typical High $12,022.64 | Facility | None | $707.95 | $4,073.80 | $12,022.64 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,737.80 Median $3,890.45 Typical High $10,964.78 | Professional | None | $1,737.80 | $3,890.45 | $10,964.78 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,595.87 | Facility | None | $1,071.52 | $3,890.45 | $16,595.87 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $7,413.10 | Professional | None | $1,862.09 | $2,511.89 | $7,413.10 |
Well Sense Setting Facility Modifier None Typical Low $1,348.96 Median $2,454.71 Typical High $4,073.80 | Facility | None | $1,348.96 | $2,454.71 | $4,073.80 |
Well Sense Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,174.90 | $1,584.89 |
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 $758.58 Median $758.58 Typical High $2,344.23 | Professional | 52 · Reduced service | $758.58 | $758.58 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $933.25 | Professional | 53 · Discontinued | $302.00 | $302.00 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $691.83 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $467.74 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $3,235.94 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,995.26 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,174.90 | $1,995.26 | $2,691.53 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $2,290.87 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,348.96 | $2,290.87 | $3,019.95 |
Where Massachusetts sits
The same service costs 7.8 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· 16th of 51
$2,570
AK $6,761TX $871
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.