How much rates vary
Facilitymedian $129 · 10th to 90th $58 to $1,698Professionalmedian $129 · 10th to 90th $69 to $309
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 $58.88 Median $147.91 Typical High $245.47 | Facility | None | $58.88 | $147.91 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $83.18 Typical High $173.78 | Professional | None | $58.88 | $83.18 | $173.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $51.29 Median $309.03 Typical High $1,862.09 | Facility | None | $51.29 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $69.18 Median $154.88 Typical High $724.44 | Professional | None | $69.18 | $154.88 | $724.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $67.61 Median $81.28 Typical High $154.88 | Facility | None | $67.61 | $81.28 | $154.88 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $67.61 Median $114.82 Typical High $199.53 | Professional | None | $67.61 | $114.82 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $125.89 Typical High $199.53 | Facility | None | $53.70 | $125.89 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $213.80 | Professional | None | $85.11 | $123.03 | $213.80 |
Fallon Health Setting Facility Modifier None Typical Low $66.07 Median $87.10 Typical High $3,311.31 | Facility | None | $66.07 | $87.10 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $169.82 | Professional | None | $128.82 | $147.91 | $169.82 |
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 $72.44 Median $147.91 Typical High $275.42 | Professional | None | $72.44 | $147.91 | $275.42 |
Health New England Setting Facility Modifier None Typical Low $138.04 Median $331.13 Typical High $616.60 | Facility | None | $138.04 | $331.13 | $616.60 |
Health New England Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $190.55 | Professional | None | $117.49 | $138.04 | $190.55 |
Mass General Brigham Setting Facility Modifier None Typical Low $51.29 Median $309.03 Typical High $1,862.09 | Facility | None | $51.29 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $69.18 Median $154.88 Typical High $724.44 | Professional | None | $69.18 | $154.88 | $724.44 |
Tufts Setting Facility Modifier None Typical Low $47.86 Median $407.38 Typical High $537.03 | Facility | None | $47.86 | $407.38 | $537.03 |
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 $75.86 Median $120.23 Typical High $281.84 | Professional | None | $75.86 | $120.23 | $281.84 |
Well Sense Setting Facility Modifier None Typical Low $46.77 Median $70.79 Typical High $109.65 | Facility | None | $46.77 | $70.79 | $109.65 |
Well Sense Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $74.13 | Professional | None | $43.65 | $58.88 | $74.13 |
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 $29.51 Median $41.69 Typical High $87.10 | Professional | 52 · Reduced service | $29.51 | $41.69 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.60 Typical High $34.67 | Professional | 53 · Discontinued | $11.75 | $16.60 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.59 Typical High $26.30 | Professional | 55 · Aftercare only | $8.71 | $12.59 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.32 Typical High $17.38 | Professional | 56 · Pre-op care only | $5.89 | $8.32 | $17.38 |
BCBS Massachusetts Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $22.91 | $39.81 | $52.48 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $93.33 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $53.70 | $93.33 | $177.83 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.18 Median $39.81 Typical High $53.70 | Professional | 78 · Unplanned return to OR | $28.18 | $39.81 | $53.70 |
Where Massachusetts sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 9th of 51
$129
AK $257KY $69.18
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.