How much rates vary
Facilitymedian $245 · 10th to 90th $93 to $2,239Professionalmedian $288 · 10th to 90th $174 to $676
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 $478.63 Median $2,187.76 Typical High $3,630.78 | Facility | None | $478.63 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $426.58 | Professional | None | $144.54 | $173.78 | $426.58 |
AllWays Health Partners Setting Facility Modifier None Typical Low $93.33 Median $446.68 Typical High $1,862.09 | Facility | None | $93.33 | $446.68 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $173.78 Median $338.84 Typical High $1,445.44 | Professional | None | $173.78 | $338.84 | $1,445.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $407.38 | Facility | None | $181.97 | $218.78 | $407.38 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $407.38 | Professional | None | $181.97 | $234.42 | $407.38 |
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 $208.93 Median $257.04 Typical High $446.68 | Professional | None | $208.93 | $257.04 | $446.68 |
Fallon Health Setting Facility Modifier None Typical Low $158.49 Median $223.87 Typical High $3,311.31 | Facility | None | $158.49 | $223.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $346.74 | Professional | None | $257.04 | $295.12 | $346.74 |
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 $186.21 Median $363.08 Typical High $562.34 | Professional | None | $186.21 | $363.08 | $562.34 |
Mass General Brigham Setting Facility Modifier None Typical Low $93.33 Median $446.68 Typical High $1,862.09 | Facility | None | $93.33 | $446.68 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $173.78 Median $338.84 Typical High $1,445.44 | Professional | None | $173.78 | $338.84 | $1,445.44 |
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 $177.83 Median $251.19 Typical High $676.08 | Professional | None | $177.83 | $251.19 | $676.08 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $158.49 Typical High $269.15 | Facility | None | $93.33 | $158.49 | $269.15 |
Well Sense Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $147.91 | Professional | None | $107.15 | $123.03 | $147.91 |
8 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 $72.44 Median $87.10 Typical High $208.93 | Professional | 52 · Reduced service | $72.44 | $87.10 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $34.67 Typical High $85.11 | Professional | 53 · Discontinued | $28.84 | $34.67 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $131.83 Typical High $316.23 | Professional | 54 · Surgery only | $109.65 | $131.83 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.30 Typical High $63.10 | Professional | 55 · Aftercare only | $21.88 | $26.30 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $17.38 Typical High $42.66 | Professional | 56 · Pre-op care only | $14.45 | $17.38 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $123.03 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $102.33 | $123.03 | $295.12 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $186.21 Typical High $288.40 | Professional | 54 · Surgery only | $125.89 | $186.21 | $288.40 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $77.62 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $67.61 | $77.62 | $104.71 |
Where Massachusetts sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$282
AK $617FL $135
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.