How much rates vary
Facilitymedian $537 · 10th to 90th $316 to $6,166Professionalmedian $1,585 · 10th to 90th $316 to $6,026
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $1,047.13 Typical High $1,949.84 | Professional | None | $208.93 | $1,047.13 | $1,949.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $741.31 Median $5,248.07 Typical High $8,709.64 | Facility | None | $741.31 | $5,248.07 | $8,709.64 |
AllWays Health Partners Setting Professional Modifier None Typical Low $338.84 Median $1,995.26 Typical High $13,182.57 | Professional | None | $338.84 | $1,995.26 | $13,182.57 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $741.31 | Facility | None | $316.23 | $316.23 | $741.31 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $316.23 Median $724.44 Typical High $2,187.76 | Professional | None | $316.23 | $724.44 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $1,412.54 Typical High $3,630.78 | Professional | None | $436.52 | $1,412.54 | $3,630.78 |
Fallon Health Setting Facility Modifier None Typical Low $295.12 Median $389.05 Typical High $3,311.31 | Facility | None | $295.12 | $389.05 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $3,801.89 | Professional | None | $2,238.72 | $2,691.53 | $3,801.89 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,398.83 Median $5,248.07 Typical High $11,481.54 | Facility | None | $2,398.83 | $5,248.07 | $11,481.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $354.81 Median $1,659.59 Typical High $5,128.61 | Professional | None | $354.81 | $1,659.59 | $5,128.61 |
Health New England Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,128.61 | Facility | None | $5,011.87 | $5,011.87 | $5,128.61 |
Mass General Brigham Setting Facility Modifier None Typical Low $741.31 Median $5,248.07 Typical High $8,709.64 | Facility | None | $741.31 | $5,248.07 | $8,709.64 |
Mass General Brigham Setting Professional Modifier None Typical Low $338.84 Median $1,995.26 Typical High $13,182.57 | Professional | None | $338.84 | $1,995.26 | $13,182.57 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $6,309.57 Typical High $11,481.54 | Facility | None | $2,398.83 | $6,309.57 | $11,481.54 |
United Setting Professional Modifier None Typical Low $398.11 Median $1,479.11 Typical High $4,897.79 | Professional | None | $398.11 | $1,479.11 | $4,897.79 |
Well Sense Setting Facility Modifier None Typical Low $275.42 Median $537.03 Typical High $2,089.30 | Facility | None | $275.42 | $537.03 | $2,089.30 |
Well Sense Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $1,513.56 | Professional | None | $229.09 | $275.42 | $1,513.56 |
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 $104.71 Median $524.81 Typical High $812.83 | Professional | 52 · Reduced service | $104.71 | $524.81 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $213.80 Typical High $323.59 | Professional | 53 · Discontinued | $41.69 | $213.80 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $794.33 Typical High $1,230.27 | Professional | 54 · Surgery only | $158.49 | $794.33 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $158.49 Typical High $245.47 | Professional | 55 · Aftercare only | $31.62 | $158.49 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $104.71 Typical High $162.18 | Professional | 56 · Pre-op care only | $20.89 | $104.71 | $162.18 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $316.23 |
Where Massachusetts sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 17th of 51
$1,585
WI $2,570MD $457
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.