How much rates vary
Facilitymedian $1,380 · 10th to 90th $676 to $6,918Professionalmedian $1,318 · 10th to 90th $724 to $3,090
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 $1,778.28 Median $2,818.38 Typical High $4,677.35 | Facility | None | $1,778.28 | $2,818.38 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $2,089.30 | Professional | None | $616.60 | $812.83 | $2,089.30 |
AllWays Health Partners Setting Facility Modifier None Typical Low $562.34 Median $2,454.71 Typical High $9,120.11 | Facility | None | $562.34 | $2,454.71 | $9,120.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $724.44 Median $1,584.89 Typical High $7,079.46 | Professional | None | $724.44 | $1,584.89 | $7,079.46 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $758.58 Median $933.25 Typical High $1,737.80 | Facility | None | $758.58 | $933.25 | $1,737.80 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,905.46 | Professional | None | $758.58 | $1,096.48 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,760.83 Typical High $10,232.93 | Facility | None | $676.08 | $6,760.83 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $2,187.76 | Professional | None | $954.99 | $1,202.26 | $2,187.76 |
Fallon Health Setting Facility Modifier None Typical Low $758.58 Median $954.99 Typical High $3,311.31 | Facility | None | $758.58 | $954.99 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,412.54 | $1,621.81 |
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 $812.83 Median $1,621.81 Typical High $2,754.23 | Professional | None | $812.83 | $1,621.81 | $2,754.23 |
Health New England Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $562.34 Median $2,454.71 Typical High $9,120.11 | Facility | None | $562.34 | $2,454.71 | $9,120.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $724.44 Median $1,584.89 Typical High $7,079.46 | Professional | None | $724.44 | $1,584.89 | $7,079.46 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $11,481.54 | Facility | None | $1,047.13 | $2,344.23 | $11,481.54 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,202.26 Typical High $3,090.30 | Professional | None | $724.44 | $1,202.26 | $3,090.30 |
Well Sense Setting Facility Modifier None Typical Low $630.96 Median $870.96 Typical High $3,548.13 | Facility | None | $630.96 | $870.96 | $3,548.13 |
Well Sense Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $794.33 | Professional | None | $537.03 | $660.69 | $794.33 |
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 $309.03 Median $407.38 Typical High $1,023.29 | Professional | 52 · Reduced service | $309.03 | $407.38 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $162.18 Typical High $416.87 | Professional | 53 · Discontinued | $123.03 | $162.18 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $602.56 Typical High $1,548.82 | Professional | 54 · Surgery only | $467.74 | $602.56 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $123.03 Typical High $309.03 | Professional | 55 · Aftercare only | $93.33 | $123.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $81.28 Typical High $208.93 | Professional | 56 · Pre-op care only | $61.66 | $81.28 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $562.34 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $436.52 | $562.34 | $1,445.44 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $416.87 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $338.84 | $416.87 | $562.34 |
Where Massachusetts sits
The same service costs 6.2 times more in Alaska than in Delaware. 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.
Physician feeFacility fee
AK $13,849DE $2,220
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.