How much rates vary
Facilitymedian $316 · 10th to 90th $93 to $2,239Professionalmedian $417 · 10th to 90th $245 to $1,047
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 $676.08 Median $2,187.76 Typical High $3,630.78 | Facility | None | $676.08 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $676.08 | Professional | None | $213.80 | $245.47 | $676.08 |
AllWays Health Partners Setting Facility Modifier None Typical Low $93.33 Median $467.74 Typical High $1,862.09 | Facility | None | $93.33 | $467.74 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $263.03 Median $501.19 Typical High $2,041.74 | Professional | None | $263.03 | $501.19 | $2,041.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $257.04 Median $316.23 Typical High $588.84 | Facility | None | $257.04 | $316.23 | $588.84 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $588.84 | Professional | None | $257.04 | $323.59 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $181.97 Typical High $263.03 | Facility | None | $53.70 | $181.97 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $645.65 | Professional | None | $316.23 | $363.08 | $645.65 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $309.03 Typical High $3,311.31 | Facility | None | $177.83 | $309.03 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $478.63 | Professional | None | $354.81 | $407.38 | $478.63 |
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 $269.15 Median $524.81 Typical High $812.83 | Professional | None | $269.15 | $524.81 | $812.83 |
Health New England Setting Facility Modifier None Typical Low $831.76 Median $912.01 Typical High $4,677.35 | Facility | None | $831.76 | $912.01 | $4,677.35 |
Mass General Brigham Setting Facility Modifier None Typical Low $93.33 Median $467.74 Typical High $1,862.09 | Facility | None | $93.33 | $467.74 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $263.03 Median $501.19 Typical High $2,041.74 | Professional | None | $263.03 | $501.19 | $2,041.74 |
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 $281.84 Median $380.19 Typical High $1,047.13 | Professional | None | $281.84 | $380.19 | $1,047.13 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $234.42 Typical High $407.38 | Facility | None | $93.33 | $234.42 | $407.38 |
Well Sense Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $223.87 | Professional | None | $165.96 | $181.97 | $223.87 |
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 $107.15 Median $120.23 Typical High $338.84 | Professional | 52 · Reduced service | $107.15 | $120.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $48.98 Typical High $134.90 | Professional | 53 · Discontinued | $42.66 | $48.98 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $181.97 Typical High $501.19 | Professional | 54 · Surgery only | $162.18 | $181.97 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $36.31 Typical High $102.33 | Professional | 55 · Aftercare only | $32.36 | $36.31 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $24.55 Typical High $67.61 | Professional | 56 · Pre-op care only | $21.38 | $24.55 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $169.82 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $151.36 | $169.82 | $478.63 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $218.78 Typical High $295.12 | Professional | 52 · Reduced service | $128.82 | $218.78 | $295.12 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $354.81 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $208.93 | $354.81 | $467.74 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $117.49 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $107.15 | $117.49 | $162.18 |
Where Massachusetts sits
The same service costs 5.1 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
$417
AK $955UT $186
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.