How much rates vary
Facilitymedian $1,096 · 10th to 90th $501 to $4,677Professionalmedian $955 · 10th to 90th $550 to $2,188
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 $1,513.56 Median $2,818.38 Typical High $5,248.07 | Facility | None | $1,513.56 | $2,818.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $1,513.56 | Professional | None | $457.09 | $645.65 | $1,513.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $5,623.41 | Facility | None | $602.56 | $2,041.74 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $4,897.79 | Professional | None | $588.84 | $1,096.48 | $4,897.79 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $501.19 Median $616.60 Typical High $1,148.15 | Facility | None | $501.19 | $616.60 | $1,148.15 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $1,288.25 | Professional | None | $501.19 | $758.58 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,187.76 Typical High $3,162.28 | Facility | None | $831.76 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,621.81 | Professional | None | $645.65 | $870.96 | $1,621.81 |
Fallon Health Setting Facility Modifier None Typical Low $501.19 Median $660.69 Typical High $3,311.31 | Facility | None | $501.19 | $660.69 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,122.02 | Professional | None | $831.76 | $954.99 | $1,122.02 |
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 $602.56 Median $1,096.48 Typical High $1,949.84 | Professional | None | $602.56 | $1,096.48 | $1,949.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $5,623.41 | Facility | None | $602.56 | $2,041.74 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $4,897.79 | Professional | None | $588.84 | $1,096.48 | $4,897.79 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $2,187.76 | Professional | None | $630.96 | $933.25 | $2,187.76 |
Well Sense Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $1,096.48 | Facility | None | $436.52 | $676.08 | $1,096.48 |
Well Sense Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $588.84 | Professional | None | $371.54 | $489.78 | $588.84 |
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 $229.09 Median $323.59 Typical High $758.58 | Professional | 52 · Reduced service | $229.09 | $323.59 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $128.82 Typical High $302.00 | Professional | 53 · Discontinued | $91.20 | $128.82 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $478.63 Typical High $1,148.15 | Professional | 54 · Surgery only | $338.84 | $478.63 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $95.50 Typical High $229.09 | Professional | 55 · Aftercare only | $69.18 | $95.50 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $64.57 Typical High $151.36 | Professional | 56 · Pre-op care only | $45.71 | $64.57 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $446.68 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $316.23 | $446.68 | $1,071.52 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $316.23 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $239.88 | $316.23 | $426.58 |
Where Massachusetts sits
The same service costs 5.8 times more in Alaska than in Texas. 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· 12th of 51
$955
AK $2,455TX $427
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.