How much rates vary
Facilitymedian $741 · 10th to 90th $302 to $3,890Professionalmedian $501 · 10th to 90th $302 to $1,288
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 $933.25 Median $2,818.38 Typical High $4,677.35 | Facility | None | $933.25 | $2,818.38 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $870.96 | Professional | None | $269.15 | $302.00 | $870.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $512.86 Median $1,380.38 Typical High $4,168.69 | Facility | None | $512.86 | $1,380.38 | $4,168.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $309.03 Median $602.56 Typical High $3,162.28 | Professional | None | $309.03 | $602.56 | $3,162.28 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $691.83 | Facility | None | $302.00 | $302.00 | $691.83 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $691.83 | Professional | None | $302.00 | $371.54 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $1,698.24 | Facility | None | $446.68 | $1,148.15 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $758.58 | Professional | None | $380.19 | $426.58 | $758.58 |
Fallon Health Setting Facility Modifier None Typical Low $295.12 Median $389.05 Typical High $3,311.31 | Facility | None | $295.12 | $389.05 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $549.54 | Professional | None | $407.38 | $478.63 | $549.54 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $331.13 Median $645.65 Typical High $1,000.00 | Professional | None | $331.13 | $645.65 | $1,000.00 |
Health New England Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Health New England Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $309.03 | Professional | None | $213.80 | $229.09 | $309.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $512.86 Median $1,380.38 Typical High $4,168.69 | Facility | None | $512.86 | $1,380.38 | $4,168.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $309.03 Median $602.56 Typical High $3,162.28 | Professional | None | $309.03 | $602.56 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $6,309.57 | Facility | None | $1,047.13 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $1,288.25 | Professional | None | $354.81 | $478.63 | $1,288.25 |
Well Sense Setting Facility Modifier None Typical Low $239.88 Median $338.84 Typical High $616.60 | Facility | None | $239.88 | $338.84 | $616.60 |
Well Sense Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $295.12 | Professional | None | $213.80 | $234.42 | $295.12 |
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 $134.90 Median $151.36 Typical High $436.52 | Professional | 52 · Reduced service | $134.90 | $151.36 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $61.66 Typical High $173.78 | Professional | 53 · Discontinued | $53.70 | $61.66 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $229.09 Typical High $645.65 | Professional | 54 · Surgery only | $204.17 | $229.09 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $128.82 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $87.10 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $213.80 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $190.55 | $213.80 | $602.56 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $151.36 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $138.04 | $151.36 | $208.93 |
Where Massachusetts sits
The same service costs 6.8 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· 11th of 51
$513
AK $1,288UT $191
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.