How much rates vary
Facilitymedian $427 · 10th to 90th $129 to $2,239Professionalmedian $501 · 10th to 90th $302 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 $371.54 Median $2,137.96 Typical High $3,388.44 | Facility | None | $371.54 | $2,137.96 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $758.58 | Professional | None | $269.15 | $302.00 | $758.58 |
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 $302.00 Median $616.60 Typical High $2,570.40 | Professional | None | $302.00 | $616.60 | $2,570.40 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $776.25 | Facility | None | $346.74 | $416.87 | $776.25 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $707.95 | Professional | None | $346.74 | $416.87 | $707.95 |
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 $407.38 Median $446.68 Typical High $794.33 | Professional | None | $407.38 | $446.68 | $794.33 |
Fallon Health Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $3,311.31 | Facility | None | $331.13 | $436.52 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $616.60 | Professional | None | $457.09 | $524.81 | $616.60 |
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 $676.08 Typical High $1,000.00 | Professional | None | $354.81 | $676.08 | $1,000.00 |
Health New England Setting Facility Modifier None Typical Low $302.00 Median $524.81 Typical High $630.96 | Facility | None | $302.00 | $524.81 | $630.96 |
Health New England Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $676.08 | Professional | None | $363.08 | $512.86 | $676.08 |
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 $302.00 Median $616.60 Typical High $2,570.40 | Professional | None | $302.00 | $616.60 | $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 $331.13 Median $467.74 Typical High $1,318.26 | Professional | None | $331.13 | $467.74 | $1,318.26 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $295.12 Typical High $512.86 | Facility | None | $93.33 | $295.12 | $512.86 |
Well Sense Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $263.03 | Professional | None | $194.98 | $218.78 | $263.03 |
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 $134.90 Median $151.36 Typical High $380.19 | Professional | 52 · Reduced service | $134.90 | $151.36 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $154.88 | Professional | 53 · Discontinued | $53.70 | $60.26 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $575.44 | Professional | 54 · Surgery only | $204.17 | $223.87 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $114.82 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $75.86 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $208.93 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $190.55 | $208.93 | $537.03 |
BCBS Massachusetts Setting Facility Modifier 54 · Surgery only Typical Low $239.88 Median $251.19 Typical High $549.54 | Facility | 54 · Surgery only | $239.88 | $251.19 | $549.54 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $467.74 Typical High $660.69 | Professional | 54 · Surgery only | $288.40 | $467.74 | $660.69 |
BCBS Massachusetts Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $117.49 Typical High $177.83 | Professional | 55 · Aftercare only | $69.18 | $117.49 | $177.83 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $141.25 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $125.89 | $141.25 | $190.55 |
Where Massachusetts sits
The same service costs 5.5 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
$501
AK $1,202UT $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.