How much rates vary
Facilitymedian $575 · 10th to 90th $129 to $2,399Professionalmedian $832 · 10th to 90th $479 to $2,291
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 $1,380.38 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,380.38 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $1,380.38 | Professional | None | $457.09 | $467.74 | $1,380.38 |
AllWays Health Partners Setting Facility Modifier None Typical Low $93.33 Median $467.74 Typical High $2,041.74 | Facility | None | $93.33 | $467.74 | $2,041.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $4,073.80 | Professional | None | $537.03 | $1,000.00 | $4,073.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $549.54 Median $660.69 Typical High $1,258.93 | Facility | None | $549.54 | $660.69 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $295.12 Typical High $776.25 | Facility | None | $204.17 | $295.12 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $1,348.96 | Professional | None | $676.08 | $691.83 | $1,348.96 |
Fallon Health Setting Facility Modifier None Typical Low $537.03 Median $691.83 Typical High $3,311.31 | Facility | None | $537.03 | $691.83 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $933.25 | Professional | None | $707.95 | $812.83 | $933.25 |
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 $575.44 Median $1,096.48 Typical High $1,659.59 | Professional | None | $575.44 | $1,096.48 | $1,659.59 |
Mass General Brigham Setting Facility Modifier None Typical Low $93.33 Median $467.74 Typical High $2,041.74 | Facility | None | $93.33 | $467.74 | $2,041.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $4,073.80 | Professional | None | $537.03 | $1,000.00 | $4,073.80 |
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 $562.34 Median $812.83 Typical High $2,290.87 | Professional | None | $562.34 | $812.83 | $2,290.87 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $489.78 Typical High $870.96 | Facility | None | $93.33 | $489.78 | $870.96 |
Well Sense Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $467.74 | Professional | None | $346.74 | $354.81 | $467.74 |
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 $229.09 Median $234.42 Typical High $691.83 | Professional | 52 · Reduced service | $229.09 | $234.42 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $93.33 Typical High $275.42 | Professional | 53 · Discontinued | $91.20 | $93.33 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $1,023.29 | Professional | 54 · Surgery only | $346.74 | $346.74 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $208.93 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $46.77 Typical High $138.04 | Professional | 56 · Pre-op care only | $45.71 | $46.77 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $954.99 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $660.69 Typical High $2,238.72 | Professional | 54 · Surgery only | $537.03 | $660.69 | $2,238.72 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $229.09 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $223.87 | $229.09 | $338.84 |
Where Massachusetts sits
The same service costs 5.2 times more in Connecticut than in Florida. 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.
Physician feeFacility fee
CT $3,486FL $668
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.