How much rates vary
Facilitymedian $355 · 10th to 90th $240 to $2,818Professionalmedian $1,349 · 10th to 90th $240 to $5,495
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $851.14 Typical High $1,445.44 | Professional | None | $154.88 | $851.14 | $1,445.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $537.03 Median $1,023.29 Typical High $3,548.13 | Facility | None | $537.03 | $1,023.29 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $257.04 Median $1,659.59 Typical High $11,220.18 | Professional | None | $257.04 | $1,659.59 | $11,220.18 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $562.34 | Facility | None | $239.88 | $239.88 | $562.34 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $239.88 Median $1,412.54 Typical High $1,862.09 | Professional | None | $239.88 | $1,412.54 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $1,122.02 Typical High $3,019.95 | Professional | None | $316.23 | $1,122.02 | $3,019.95 |
Fallon Health Setting Facility Modifier None Typical Low $223.87 Median $295.12 Typical High $3,311.31 | Facility | None | $223.87 | $295.12 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $3,235.94 | Professional | None | $1,905.46 | $2,344.23 | $3,235.94 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $269.15 Median $1,258.93 Typical High $4,365.16 | Professional | None | $269.15 | $1,258.93 | $4,365.16 |
Mass General Brigham Setting Facility Modifier None Typical Low $537.03 Median $1,023.29 Typical High $3,548.13 | Facility | None | $537.03 | $1,023.29 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $257.04 Median $1,659.59 Typical High $11,220.18 | Professional | None | $257.04 | $1,659.59 | $11,220.18 |
United Setting Facility Modifier None Typical Low $741.31 Median $2,041.74 Typical High $3,548.13 | Facility | None | $741.31 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $281.84 Median $1,230.27 Typical High $3,981.07 | Professional | None | $281.84 | $1,230.27 | $3,981.07 |
Well Sense Setting Facility Modifier None Typical Low $208.93 Median $407.38 Typical High $1,698.24 | Facility | None | $208.93 | $407.38 | $1,698.24 |
Well Sense Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $1,174.90 | Professional | None | $177.83 | $208.93 | $1,174.90 |
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 $77.62 Median $457.09 Typical High $645.65 | Professional | 52 · Reduced service | $77.62 | $457.09 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $181.97 Typical High $263.03 | Professional | 53 · Discontinued | $30.90 | $181.97 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $691.83 Typical High $977.24 | Professional | 54 · Surgery only | $114.82 | $691.83 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $138.04 Typical High $194.98 | Professional | 55 · Aftercare only | $22.91 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $91.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $15.49 | $91.20 | $131.83 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $239.88 |
Where Massachusetts sits
The same service costs 6.5 times more in Washington 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· 19th of 51
$1,288
WA $2,138MD $331
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.