How much rates vary
Facilitymedian $676 · 10th to 90th $269 to $5,248Professionalmedian $631 · 10th to 90th $302 to $1,995
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 $1,318.26 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,318.26 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $707.95 | Professional | None | $302.00 | $446.68 | $707.95 |
AllWays Health Partners Setting Facility Modifier None Typical Low $524.81 Median $1,949.84 Typical High $5,623.41 | Facility | None | $524.81 | $1,949.84 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $309.03 Median $691.83 Typical High $3,715.35 | Professional | None | $309.03 | $691.83 | $3,715.35 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $616.60 | Facility | None | $269.15 | $269.15 | $616.60 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $912.01 | Professional | None | $269.15 | $478.63 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $426.58 Typical High $954.99 | Facility | None | $302.00 | $426.58 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $1,174.90 | Professional | None | $416.87 | $676.08 | $1,174.90 |
Fallon Health Setting Facility Modifier None Typical Low $269.15 Median $346.74 Typical High $3,311.31 | Facility | None | $269.15 | $346.74 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $724.44 | Professional | None | $501.19 | $588.84 | $724.44 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $295.12 Median $676.08 Typical High $1,318.26 | Professional | None | $295.12 | $676.08 | $1,318.26 |
Health New England Setting Facility Modifier None Typical Low $2,951.21 Median $3,388.44 Typical High $10,964.78 | Facility | None | $2,951.21 | $3,388.44 | $10,964.78 |
Health New England Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Mass General Brigham Setting Facility Modifier None Typical Low $524.81 Median $1,949.84 Typical High $5,623.41 | Facility | None | $524.81 | $1,949.84 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $309.03 Median $691.83 Typical High $3,715.35 | Professional | None | $309.03 | $691.83 | $3,715.35 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $363.08 Median $707.95 Typical High $1,513.56 | Professional | None | $363.08 | $707.95 | $1,513.56 |
Well Sense Setting Facility Modifier None Typical Low $208.93 Median $338.84 Typical High $630.96 | Facility | None | $208.93 | $338.84 | $630.96 |
Well Sense Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $346.74 | Professional | None | $194.98 | $234.42 | $346.74 |
8 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 $151.36 Median $223.87 Typical High $295.12 | Professional | 52 · Reduced service | $151.36 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $89.13 Typical High $120.23 | Professional | 53 · Discontinued | $60.26 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $338.84 Typical High $446.68 | Professional | 54 · Surgery only | $223.87 | $338.84 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $67.61 Typical High $89.13 | Professional | 55 · Aftercare only | $44.67 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $44.67 Typical High $58.88 | Professional | 56 · Pre-op care only | $30.20 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $316.23 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $208.93 | $316.23 | $416.87 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $575.44 Typical High $758.58 | Professional | 54 · Surgery only | $436.52 | $575.44 | $758.58 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $660.69 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $501.19 | $660.69 | $870.96 |
Where Massachusetts sits
The same service costs 4.1 times more in Wisconsin than in Texas. 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· 23rd of 51
$631
WI $1,549TX $380
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.