How much rates vary
Facilitymedian $447 · 10th to 90th $129 to $2,239Professionalmedian $550 · 10th to 90th $316 to $1,413
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 $812.83 Median $2,187.76 Typical High $3,630.78 | Facility | None | $812.83 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $812.83 | Professional | None | $288.40 | $316.23 | $812.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $93.33 Median $380.19 Typical High $1,862.09 | Facility | None | $93.33 | $380.19 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $354.81 Median $660.69 Typical High $2,754.23 | Professional | None | $354.81 | $660.69 | $2,754.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $371.54 Median $446.68 Typical High $851.14 | Facility | None | $371.54 | $446.68 | $851.14 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $851.14 | Professional | None | $371.54 | $446.68 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $295.12 Typical High $489.78 | Facility | None | $204.17 | $295.12 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $870.96 | Professional | None | $436.52 | $478.63 | $870.96 |
Fallon Health Setting Facility Modifier None Typical Low $363.08 Median $478.63 Typical High $3,311.31 | Facility | None | $363.08 | $478.63 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $660.69 | Professional | None | $489.78 | $562.34 | $660.69 |
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 $389.05 Median $724.44 Typical High $1,071.52 | Professional | None | $389.05 | $724.44 | $1,071.52 |
Health New England Setting Facility Modifier None Typical Low $602.56 Median $691.83 Typical High $794.33 | Facility | None | $602.56 | $691.83 | $794.33 |
Health New England Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $93.33 Median $380.19 Typical High $1,862.09 | Facility | None | $93.33 | $380.19 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $354.81 Median $660.69 Typical High $2,754.23 | Professional | None | $354.81 | $660.69 | $2,754.23 |
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 $354.81 Median $501.19 Typical High $1,412.54 | Professional | None | $354.81 | $501.19 | $1,412.54 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $316.23 Typical High $549.54 | Facility | None | $93.33 | $316.23 | $549.54 |
Well Sense Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $281.84 | Professional | None | $208.93 | $229.09 | $281.84 |
9 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 $144.54 Median $158.49 Typical High $407.38 | Professional | 52 · Reduced service | $144.54 | $158.49 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $63.10 Typical High $162.18 | Professional | 53 · Discontinued | $57.54 | $63.10 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $239.88 Typical High $616.60 | Professional | 54 · Surgery only | $213.80 | $239.88 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $47.86 Typical High $123.03 | Professional | 55 · Aftercare only | $42.66 | $47.86 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $31.62 Typical High $81.28 | Professional | 56 · Pre-op care only | $28.84 | $31.62 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $223.87 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $199.53 | $223.87 | $575.44 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $436.52 Typical High $1,548.82 | Professional | 54 · Surgery only | $263.03 | $436.52 | $1,548.82 |
BCBS Massachusetts Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $151.36 Typical High $204.17 | Professional | 55 · Aftercare only | $89.13 | $151.36 | $204.17 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $147.91 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $134.90 | $147.91 | $199.53 |
Where Massachusetts sits
The same service costs 5.9 times more in Alaska than in Utah. 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
$537
AK $1,288UT $219
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.