How much rates vary
Facilitymedian $339 · 10th to 90th $224 to $2,818Professionalmedian $1,380 · 10th to 90th $224 to $6,310
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 $2,691.53 Typical High $3,715.35 | Facility | None | $1,000.00 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $758.58 Typical High $1,698.24 | Professional | None | $165.96 | $758.58 | $1,698.24 |
AllWays Health Partners Setting Facility Modifier None Typical Low $501.19 Median $1,023.29 Typical High $3,548.13 | Facility | None | $501.19 | $1,023.29 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $281.84 Median $1,949.84 Typical High $8,912.51 | Professional | None | $281.84 | $1,949.84 | $8,912.51 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $524.81 | Facility | None | $223.87 | $223.87 | $524.81 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $223.87 Median $1,445.44 Typical High $2,137.96 | Professional | None | $223.87 | $1,445.44 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $794.33 Typical High $2,884.03 | Professional | None | $331.13 | $794.33 | $2,884.03 |
Fallon Health Setting Facility Modifier None Typical Low $229.09 Median $281.84 Typical High $3,311.31 | Facility | None | $229.09 | $281.84 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,479.11 | $1,819.70 | $2,511.89 |
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 $251.19 Median $1,202.26 Typical High $3,548.13 | Professional | None | $251.19 | $1,202.26 | $3,548.13 |
Health New England Setting Facility Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $16,595.87 | Facility | None | $16,595.87 | $16,595.87 | $16,595.87 |
Health New England Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $501.19 Median $1,023.29 Typical High $3,548.13 | Facility | None | $501.19 | $1,023.29 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $281.84 Median $1,949.84 Typical High $8,912.51 | Professional | None | $281.84 | $1,949.84 | $8,912.51 |
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 $275.42 Median $1,047.13 Typical High $3,981.07 | Professional | None | $275.42 | $1,047.13 | $3,981.07 |
Well Sense Setting Facility Modifier None Typical Low $199.53 Median $389.05 Typical High $1,584.89 | Facility | None | $199.53 | $389.05 | $1,584.89 |
Well Sense Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $1,174.90 | Professional | None | $194.98 | $234.42 | $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 $83.18 Median $489.78 Typical High $691.83 | Professional | 52 · Reduced service | $83.18 | $489.78 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $194.98 Typical High $275.42 | Professional | 53 · Discontinued | $33.11 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $724.44 Typical High $1,047.13 | Professional | 54 · Surgery only | $125.89 | $724.44 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $147.91 Typical High $208.93 | Professional | 55 · Aftercare only | $25.12 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $97.72 Typical High $138.04 | Professional | 56 · Pre-op care only | $16.60 | $97.72 | $138.04 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $223.87 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $199.53 | $223.87 | $263.03 |
Where Massachusetts sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 11th of 51
$1,318
WA $1,820HI $316
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.