How much rates vary
Facilitymedian $1,175 · 10th to 90th $316 to $5,012Professionalmedian $676 · 10th to 90th $355 to $3,981
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 $1,412.54 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,412.54 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,047.13 | Professional | None | $457.09 | $457.09 | $1,047.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $5,888.44 | Facility | None | $602.56 | $2,041.74 | $5,888.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $446.68 Median $1,258.93 Typical High $3,981.07 | Professional | None | $446.68 | $1,258.93 | $3,981.07 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $1,047.13 | Professional | None | $467.74 | $707.95 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $3,311.31 | Facility | None | $831.76 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,513.56 | Professional | None | $616.60 | $616.60 | $1,513.56 |
Fallon Health Setting Facility Modifier None Typical Low $269.15 Median $524.81 Typical High $2,691.53 | Facility | None | $269.15 | $524.81 | $2,691.53 |
Fallon Health Setting Professional Modifier None Typical Low $257.04 Median $467.74 Typical High $676.08 | Professional | None | $257.04 | $467.74 | $676.08 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $501.19 Median $933.25 Typical High $1,621.81 | Professional | None | $501.19 | $933.25 | $1,621.81 |
Health New England Setting Facility Modifier None Typical Low $5,011.87 Median $5,128.61 Typical High $6,606.93 | Facility | None | $5,011.87 | $5,128.61 | $6,606.93 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $5,888.44 | Facility | None | $602.56 | $2,041.74 | $5,888.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $446.68 Median $1,258.93 Typical High $3,981.07 | Professional | None | $446.68 | $1,258.93 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,332.54 | Facility | None | $1,047.13 | $2,344.23 | $9,332.54 |
United Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,862.09 | Professional | None | $489.78 | $691.83 | $1,862.09 |
Well Sense Setting Facility Modifier None Typical Low $371.54 Median $588.84 Typical High $1,174.90 | Facility | None | $371.54 | $588.84 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $426.58 | Professional | None | $354.81 | $354.81 | $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 $229.09 Median $229.09 Typical High $707.95 | Professional | 52 · Reduced service | $229.09 | $229.09 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $288.40 | Professional | 53 · Discontinued | $91.20 | $91.20 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $1,071.52 | Professional | 54 · Surgery only | $346.74 | $346.74 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $213.80 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $141.25 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $1,000.00 |
Where Massachusetts sits
The same service costs 8.7 times more in Oklahoma than in Utah. 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
$692
OK $2,951UT $339
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.