How much rates vary
Facilitymedian $191 · 10th to 90th $87 to $2,042Professionalmedian $295 · 10th to 90th $135 to $1,023
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 $102.33 Median $2,691.53 Typical High $5,128.61 | Facility | None | $102.33 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $354.81 | Professional | None | $102.33 | $190.55 | $354.81 |
AllWays Health Partners Setting Facility Modifier None Typical Low $83.18 Median $295.12 Typical High $1,862.09 | Facility | None | $83.18 | $295.12 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $141.25 Median $346.74 Typical High $1,584.89 | Professional | None | $141.25 | $346.74 | $1,584.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $316.23 | Facility | None | $134.90 | $134.90 | $316.23 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $630.96 | Professional | None | $177.83 | $309.03 | $630.96 |
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 $158.49 Median $275.42 Typical High $562.34 | Professional | None | $158.49 | $275.42 | $562.34 |
Fallon Health Setting Facility Modifier None Typical Low $120.23 Median $169.82 Typical High $3,311.31 | Facility | None | $120.23 | $169.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $398.11 | Professional | None | $263.03 | $316.23 | $398.11 |
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 $141.25 Median $302.00 Typical High $602.56 | Professional | None | $141.25 | $302.00 | $602.56 |
Health New England Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $165.96 | Facility | None | $89.13 | $89.13 | $165.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $83.18 Median $295.12 Typical High $1,862.09 | Facility | None | $83.18 | $295.12 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $141.25 Median $346.74 Typical High $1,584.89 | Professional | None | $141.25 | $346.74 | $1,584.89 |
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 $147.91 Median $275.42 Typical High $645.65 | Professional | None | $147.91 | $275.42 | $645.65 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $169.82 Typical High $263.03 | Facility | None | $97.72 | $169.82 | $263.03 |
Well Sense Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $199.53 | Professional | None | $91.20 | $109.65 | $199.53 |
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 $51.29 Median $95.50 Typical High $177.83 | Professional | 52 · Reduced service | $51.29 | $95.50 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $38.02 Typical High $70.79 | Professional | 53 · Discontinued | $20.42 | $38.02 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $144.54 Typical High $263.03 | Professional | 54 · Surgery only | $75.86 | $144.54 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $28.84 Typical High $52.48 | Professional | 55 · Aftercare only | $15.14 | $28.84 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $19.05 Typical High $35.48 | Professional | 56 · Pre-op care only | $10.23 | $19.05 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $134.90 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $70.79 | $134.90 | $245.47 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $117.49 Typical High $239.88 | Professional | 52 · Reduced service | $95.50 | $117.49 | $239.88 |
Where Massachusetts sits
The same service costs 4.5 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· 8th of 51
$275
AK $501KY $112
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.