How much rates vary
Facilitymedian $91 · 10th to 90th $47 to $1,862Professionalmedian $95 · 10th to 90th $48 to $240
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 $37.15 Median $77.62 Typical High $158.49 | Facility | None | $37.15 | $77.62 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $61.66 Typical High $120.23 | Professional | None | $37.15 | $61.66 | $120.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $234.42 Typical High $1,862.09 | Facility | None | $50.12 | $234.42 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $47.86 Median $112.20 Typical High $588.84 | Professional | None | $47.86 | $112.20 | $588.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $47.86 Median $57.54 Typical High $107.15 | Facility | None | $47.86 | $57.54 | $107.15 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $47.86 Median $95.50 Typical High $162.18 | Professional | None | $47.86 | $95.50 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $100.00 | Facility | None | $50.12 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $162.18 | Professional | None | $54.95 | $95.50 | $162.18 |
Fallon Health Setting Facility Modifier None Typical Low $46.77 Median $61.66 Typical High $3,311.31 | Facility | None | $46.77 | $61.66 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $141.25 | Professional | None | $104.71 | $120.23 | $141.25 |
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 $50.12 Median $107.15 Typical High $223.87 | Professional | None | $50.12 | $107.15 | $223.87 |
Health New England Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $309.03 | Facility | None | $117.49 | $190.55 | $309.03 |
Health New England Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $123.03 | Professional | None | $89.13 | $107.15 | $123.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $234.42 Typical High $1,862.09 | Facility | None | $50.12 | $234.42 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $47.86 Median $112.20 Typical High $588.84 | Professional | None | $47.86 | $112.20 | $588.84 |
United Setting Facility Modifier None Typical Low $123.03 Median $524.81 Typical High $2,754.23 | Facility | None | $123.03 | $524.81 | $2,754.23 |
United Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $199.53 | Professional | None | $50.12 | $87.10 | $199.53 |
Well Sense Setting Facility Modifier None Typical Low $31.62 Median $57.54 Typical High $81.28 | Facility | None | $31.62 | $57.54 | $81.28 |
Well Sense Setting Professional Modifier None Typical Low $30.20 Median $40.74 Typical High $57.54 | Professional | None | $30.20 | $40.74 | $57.54 |
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 $18.20 Median $30.90 Typical High $58.88 | Professional | 52 · Reduced service | $18.20 | $30.90 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $12.30 Typical High $23.99 | Professional | 53 · Discontinued | $7.41 | $12.30 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $9.33 Typical High $17.78 | Professional | 55 · Aftercare only | $5.50 | $9.33 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.17 Typical High $12.02 | Professional | 56 · Pre-op care only | $3.72 | $6.17 | $12.02 |
BCBS Massachusetts Setting Facility Modifier 54 · Surgery only Typical Low $33.11 Median $34.67 Typical High $75.86 | Facility | 54 · Surgery only | $33.11 | $34.67 | $75.86 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $72.44 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $38.02 | $72.44 | $162.18 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.50 Median $29.51 Typical High $41.69 | Professional | 78 · Unplanned return to OR | $19.50 | $29.51 | $41.69 |
Where Massachusetts sits
The same service costs 4.0 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
$95.50
AK $195KY $48.98
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.