How much rates vary
Facilitymedian $132 · 10th to 90th $69 to $6,607Professionalmedian $407 · 10th to 90th $74 to $1,514
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 $95.50 Median $295.12 Typical High $478.63 | Professional | None | $95.50 | $295.12 | $478.63 |
AllWays Health Partners Setting Facility Modifier None Typical Low $158.49 Median $5,248.07 Typical High $9,549.93 | Facility | None | $158.49 | $5,248.07 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $91.20 Median $467.74 Typical High $2,951.21 | Professional | None | $91.20 | $467.74 | $2,951.21 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $158.49 | Facility | None | $69.18 | $69.18 | $158.49 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $69.18 Median $489.78 Typical High $489.78 | Professional | None | $69.18 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $309.03 Typical High $977.24 | Professional | None | $109.65 | $309.03 | $977.24 |
Fallon Health Setting Facility Modifier None Typical Low $69.18 Median $85.11 Typical High $3,311.31 | Facility | None | $69.18 | $85.11 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $851.14 | Professional | None | $501.19 | $602.56 | $851.14 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,398.83 Median $5,248.07 Typical High $11,481.54 | Facility | None | $2,398.83 | $5,248.07 | $11,481.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $74.13 Median $398.11 Typical High $1,202.26 | Professional | None | $74.13 | $398.11 | $1,202.26 |
Health New England Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Mass General Brigham Setting Facility Modifier None Typical Low $158.49 Median $5,248.07 Typical High $9,549.93 | Facility | None | $158.49 | $5,248.07 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $91.20 Median $467.74 Typical High $2,951.21 | Professional | None | $91.20 | $467.74 | $2,951.21 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $6,309.57 Typical High $12,302.69 | Facility | None | $2,398.83 | $6,309.57 | $12,302.69 |
United Setting Professional Modifier None Typical Low $91.20 Median $389.05 Typical High $1,412.54 | Professional | None | $91.20 | $389.05 | $1,412.54 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $120.23 Typical High $549.54 | Facility | None | $60.26 | $120.23 | $549.54 |
Well Sense Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $302.00 | Professional | None | $213.80 | $251.19 | $302.00 |
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 $47.86 Median $131.83 Typical High $194.98 | Professional | 52 · Reduced service | $47.86 | $131.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $53.70 Typical High $79.43 | Professional | 53 · Discontinued | $19.05 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $199.53 Typical High $295.12 | Professional | 54 · Surgery only | $70.79 | $199.53 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $39.81 Typical High $58.88 | Professional | 55 · Aftercare only | $14.13 | $39.81 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $26.30 Typical High $39.81 | Professional | 56 · Pre-op care only | $9.55 | $26.30 | $39.81 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $21.88 Typical High $38.90 | Professional | 53 · Discontinued | $16.98 | $21.88 | $38.90 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $69.18 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $54.95 | $69.18 | $91.20 |
Where Massachusetts sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 15th of 51
$398
WI $617MD $110
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.