How much rates vary
Facilitymedian $100 · 10th to 90th $42 to $1,820Professionalmedian $110 · 10th to 90th $54 to $295
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 $54.95 Median $85.11 Typical High $173.78 | Facility | None | $54.95 | $85.11 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $85.11 Typical High $165.96 | Professional | None | $54.95 | $85.11 | $165.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $257.04 Typical High $1,862.09 | Facility | None | $50.12 | $257.04 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $54.95 Median $112.20 Typical High $707.95 | Professional | None | $54.95 | $112.20 | $707.95 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $40.74 Median $48.98 Typical High $93.33 | Facility | None | $40.74 | $48.98 | $93.33 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $40.74 Median $114.82 Typical High $199.53 | Professional | None | $40.74 | $114.82 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $100.00 Typical High $128.82 | Facility | None | $53.70 | $100.00 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $114.82 Typical High $199.53 | Professional | None | $52.48 | $114.82 | $199.53 |
Fallon Health Setting Facility Modifier None Typical Low $41.69 Median $53.70 Typical High $3,311.31 | Facility | None | $41.69 | $53.70 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $169.82 | Professional | None | $125.89 | $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 $53.70 Median $112.20 Typical High $275.42 | Professional | None | $53.70 | $112.20 | $275.42 |
Health New England Setting Facility Modifier None Typical Low $102.33 Median $154.88 Typical High $269.15 | Facility | None | $102.33 | $154.88 | $269.15 |
Health New England Setting Professional Modifier None Typical Low $63.10 Median $134.90 Typical High $177.83 | Professional | None | $63.10 | $134.90 | $177.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $257.04 Typical High $1,862.09 | Facility | None | $50.12 | $257.04 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $54.95 Median $112.20 Typical High $707.95 | Professional | None | $54.95 | $112.20 | $707.95 |
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 $56.23 Median $109.65 Typical High $245.47 | Professional | None | $56.23 | $109.65 | $245.47 |
Well Sense Setting Facility Modifier None Typical Low $36.31 Median $53.70 Typical High $95.50 | Facility | None | $36.31 | $53.70 | $95.50 |
Well Sense Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $72.44 | Professional | None | $41.69 | $57.54 | $72.44 |
6 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 $27.54 Median $41.69 Typical High $83.18 | Professional | 52 · Reduced service | $27.54 | $41.69 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.98 Typical High $33.11 | Professional | 53 · Discontinued | $10.96 | $16.98 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.59 Typical High $24.55 | Professional | 55 · Aftercare only | $8.32 | $12.59 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.51 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.50 | $8.51 | $16.60 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $63.10 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $38.90 | $63.10 | $177.83 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $26.92 Median $38.90 Typical High $52.48 | Professional | 78 · Unplanned return to OR | $26.92 | $38.90 | $52.48 |
Where Massachusetts sits
The same service costs 3.8 times more in Alaska than in Virginia. 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
$110
AK $214VA $56.23
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.