How much rates vary
Facilitymedian $676 · 10th to 90th $339 to $3,388Professionalmedian $646 · 10th to 90th $355 to $1,445
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 $2,691.53 Typical High $3,715.35 | Facility | None | $933.25 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $933.25 | Professional | None | $295.12 | $457.09 | $933.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $3,630.78 | Facility | None | $446.68 | $1,096.48 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $389.05 Median $758.58 Typical High $3,388.44 | Professional | None | $389.05 | $758.58 | $3,388.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $331.13 Median $407.38 Typical High $758.58 | Facility | None | $331.13 | $407.38 | $758.58 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $912.01 | Professional | None | $331.13 | $537.03 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,445.44 | Facility | None | $588.84 | $1,000.00 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $616.60 Typical High $1,148.15 | Professional | None | $416.87 | $616.60 | $1,148.15 |
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 $588.84 Median $691.83 Typical High $794.33 | Professional | None | $588.84 | $691.83 | $794.33 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $389.05 Median $758.58 Typical High $1,348.96 | Professional | None | $389.05 | $758.58 | $1,348.96 |
Health New England Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Facility | None | $7,079.46 | $7,079.46 | $7,079.46 |
Health New England Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | None | $398.11 | $467.74 | $467.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $3,630.78 | Facility | None | $446.68 | $1,096.48 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $389.05 Median $758.58 Typical High $3,388.44 | Professional | None | $389.05 | $758.58 | $3,388.44 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,456.54 | Facility | None | $575.44 | $1,380.38 | $6,456.54 |
United Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $1,412.54 | Professional | None | $407.38 | $630.96 | $1,412.54 |
Well Sense Setting Facility Modifier None Typical Low $281.84 Median $478.63 Typical High $616.60 | Facility | None | $281.84 | $478.63 | $616.60 |
Well Sense Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $398.11 | Professional | None | $234.42 | $316.23 | $398.11 |
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 $147.91 Median $229.09 Typical High $467.74 | Professional | 52 · Reduced service | $147.91 | $229.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $91.20 Typical High $186.21 | Professional | 53 · Discontinued | $58.88 | $91.20 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $338.84 Typical High $707.95 | Professional | 54 · Surgery only | $218.78 | $338.84 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $67.61 Typical High $141.25 | Professional | 55 · Aftercare only | $43.65 | $67.61 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $45.71 Typical High $93.33 | Professional | 56 · Pre-op care only | $29.51 | $45.71 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $316.23 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $204.17 | $316.23 | $660.69 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $213.80 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $147.91 | $213.80 | $288.40 |
Where Massachusetts sits
The same service costs 4.9 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
$646
AK $1,413UT $288
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.