How much rates vary
Facilitymedian $479 · 10th to 90th $89 to $3,090Professionalmedian $257 · 10th to 90th $95 to $851
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $177.83 Typical High $346.74 | Professional | None | $77.62 | $177.83 | $346.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $602.56 Typical High $2,454.71 | Facility | None | $323.59 | $602.56 | $2,454.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $107.15 Median $288.40 Typical High $2,398.83 | Professional | None | $107.15 | $288.40 | $2,398.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $87.10 Median $104.71 Typical High $199.53 | Facility | None | $87.10 | $104.71 | $199.53 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $87.10 Median $251.19 Typical High $446.68 | Professional | None | $87.10 | $251.19 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,511.89 Typical High $3,162.28 | Facility | None | $478.63 | $2,511.89 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $309.03 Typical High $489.78 | Professional | None | $128.82 | $309.03 | $489.78 |
Fallon Health Setting Facility Modifier None Typical Low $87.10 Median $114.82 Typical High $3,311.31 | Facility | None | $87.10 | $114.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $380.19 | Professional | None | $263.03 | $309.03 | $380.19 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $95.50 Median $257.04 Typical High $645.65 | Professional | None | $95.50 | $257.04 | $645.65 |
Health New England Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Health New England Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $602.56 Typical High $2,454.71 | Facility | None | $323.59 | $602.56 | $2,454.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $107.15 Median $288.40 Typical High $2,398.83 | Professional | None | $107.15 | $288.40 | $2,398.83 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $7,244.36 | Facility | None | $407.38 | $870.96 | $7,244.36 |
United Setting Professional Modifier None Typical Low $112.20 Median $275.42 Typical High $645.65 | Professional | None | $112.20 | $275.42 | $645.65 |
Well Sense Setting Facility Modifier None Typical Low $74.13 Median $173.78 Typical High $489.78 | Facility | None | $74.13 | $173.78 | $489.78 |
Well Sense Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $204.17 | Professional | None | $91.20 | $109.65 | $204.17 |
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 $38.90 Median $89.13 Typical High $181.97 | Professional | 52 · Reduced service | $38.90 | $89.13 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $35.48 Typical High $72.44 | Professional | 53 · Discontinued | $15.49 | $35.48 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $134.90 Typical High $275.42 | Professional | 54 · Surgery only | $57.54 | $134.90 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $26.92 Typical High $54.95 | Professional | 55 · Aftercare only | $11.48 | $26.92 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $17.78 Typical High $36.31 | Professional | 56 · Pre-op care only | $7.76 | $17.78 | $36.31 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $117.49 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $91.20 | $117.49 | $158.49 |
Where Massachusetts sits
The same service costs 4.1 times more in Alaska than in Nebraska. 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· 26th of 51
$275
AK $646NE $158
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.