How much rates vary
Facilitymedian $562 · 10th to 90th $158 to $3,311Professionalmedian $708 · 10th to 90th $158 to $2,291
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 $97.72 Median $416.87 Typical High $812.83 | Professional | None | $97.72 | $416.87 | $812.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $331.13 Median $870.96 Typical High $3,311.31 | Facility | None | $331.13 | $870.96 | $3,311.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $177.83 Median $794.33 Typical High $5,128.61 | Professional | None | $177.83 | $794.33 | $5,128.61 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $371.54 | Facility | None | $158.49 | $158.49 | $371.54 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $158.49 Median $831.76 Typical High $831.76 | Professional | None | $158.49 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $1,122.02 | Facility | None | $676.08 | $954.99 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $588.84 Typical High $1,584.89 | Professional | None | $257.04 | $588.84 | $1,584.89 |
Fallon Health Setting Facility Modifier None Typical Low $147.91 Median $199.53 Typical High $3,311.31 | Facility | None | $147.91 | $199.53 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,445.44 | Professional | None | $851.14 | $1,047.13 | $1,445.44 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $177.83 Median $724.44 Typical High $1,995.26 | Professional | None | $177.83 | $724.44 | $1,995.26 |
Health New England Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,000.00 | Professional | None | $501.19 | $501.19 | $1,000.00 |
Mass General Brigham Setting Facility Modifier None Typical Low $331.13 Median $870.96 Typical High $3,311.31 | Facility | None | $331.13 | $870.96 | $3,311.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $177.83 Median $794.33 Typical High $5,128.61 | Professional | None | $177.83 | $794.33 | $5,128.61 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,165.95 | Facility | None | $575.44 | $1,380.38 | $6,165.95 |
United Setting Professional Modifier None Typical Low $199.53 Median $724.44 Typical High $2,137.96 | Professional | None | $199.53 | $724.44 | $2,137.96 |
Well Sense Setting Facility Modifier None Typical Low $144.54 Median $489.78 Typical High $912.01 | Facility | None | $144.54 | $489.78 | $912.01 |
Well Sense Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $467.74 | Professional | None | $100.00 | $120.23 | $467.74 |
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 $48.98 Median $208.93 Typical High $288.40 | Professional | 52 · Reduced service | $48.98 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $83.18 Typical High $117.49 | Professional | 53 · Discontinued | $19.95 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $309.03 Typical High $436.52 | Professional | 54 · Surgery only | $74.13 | $309.03 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $61.66 Typical High $87.10 | Professional | 55 · Aftercare only | $14.79 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $41.69 Typical High $51.29 | Professional | 56 · Pre-op care only | $9.77 | $41.69 | $51.29 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $549.54 Typical High $933.25 | Professional | 52 · Reduced service | $416.87 | $549.54 | $933.25 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $660.69 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $194.98 | $660.69 | $1,445.44 |
Where Massachusetts sits
The same service costs 5.2 times more in Wisconsin 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· 12th of 51
$708
WI $1,148HI $219
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.