How much rates vary
Facilitymedian $724 · 10th to 90th $331 to $5,248Professionalmedian $759 · 10th to 90th $363 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 $1,584.89 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,584.89 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $870.96 | Professional | None | $363.08 | $537.03 | $870.96 |
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 $371.54 Median $831.76 Typical High $4,570.88 | Professional | None | $371.54 | $831.76 | $4,570.88 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $741.31 | Facility | None | $331.13 | $331.13 | $741.31 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $331.13 Median $562.34 Typical High $1,023.29 | Professional | None | $331.13 | $562.34 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $478.63 Typical High $954.99 | Facility | None | $338.84 | $478.63 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,445.44 | Professional | None | $512.86 | $794.33 | $1,445.44 |
Fallon Health Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $3,311.31 | Facility | None | $331.13 | $426.58 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $851.14 | Professional | None | $588.84 | $691.83 | $851.14 |
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 $363.08 Median $812.83 Typical High $1,621.81 | Professional | None | $363.08 | $812.83 | $1,621.81 |
Health New England Setting Facility Modifier None Typical Low $2,951.21 Median $3,388.44 Typical High $12,302.69 | Facility | None | $2,951.21 | $3,388.44 | $12,302.69 |
Health New England Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,023.29 | Professional | None | $512.86 | $512.86 | $1,023.29 |
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 $371.54 Median $831.76 Typical High $4,570.88 | Professional | None | $371.54 | $831.76 | $4,570.88 |
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 $446.68 Median $851.14 Typical High $1,778.28 | Professional | None | $446.68 | $851.14 | $1,778.28 |
Well Sense Setting Facility Modifier None Typical Low $234.42 Median $407.38 Typical High $741.31 | Facility | None | $234.42 | $407.38 | $741.31 |
Well Sense Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $426.58 | Professional | None | $239.88 | $288.40 | $426.58 |
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 $181.97 Median $263.03 Typical High $354.81 | Professional | 52 · Reduced service | $181.97 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $107.15 Typical High $144.54 | Professional | 53 · Discontinued | $72.44 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $398.11 Typical High $537.03 | Professional | 54 · Surgery only | $275.42 | $398.11 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $79.43 Typical High $107.15 | Professional | 55 · Aftercare only | $54.95 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $53.70 Typical High $72.44 | Professional | 56 · Pre-op care only | $36.31 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $371.54 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $257.04 | $371.54 | $501.19 |
Where Massachusetts sits
The same service costs 4.3 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
$759
WI $1,862TX $437
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.