How much rates vary
Facilitymedian $617 · 10th to 90th $178 to $3,802Professionalmedian $501 · 10th to 90th $251 to $1,549
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 $407.38 Median $2,691.53 Typical High $3,630.78 | Facility | None | $407.38 | $2,691.53 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $724.44 | Professional | None | $234.42 | $407.38 | $724.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $446.68 Median $1,445.44 Typical High $4,265.80 | Facility | None | $446.68 | $1,445.44 | $4,265.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $281.84 Median $630.96 Typical High $3,162.28 | Professional | None | $281.84 | $630.96 | $3,162.28 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $251.19 Median $302.00 Typical High $562.34 | Facility | None | $251.19 | $302.00 | $562.34 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $741.31 | Professional | None | $251.19 | $407.38 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,318.26 Typical High $1,949.84 | Facility | None | $446.68 | $1,318.26 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $891.25 | Professional | None | $316.23 | $467.74 | $891.25 |
Fallon Health Setting Facility Modifier None Typical Low $138.04 Median $269.15 Typical High $478.63 | Facility | None | $138.04 | $269.15 | $478.63 |
Fallon Health Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $575.44 | Professional | None | $223.87 | $398.11 | $575.44 |
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 $263.03 Median $575.44 Typical High $1,023.29 | Professional | None | $263.03 | $575.44 | $1,023.29 |
Health New England Setting Facility Modifier None Typical Low $1,202.26 Median $3,715.35 Typical High $5,011.87 | Facility | None | $1,202.26 | $3,715.35 | $5,011.87 |
Health New England Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $794.33 | Professional | None | $512.86 | $512.86 | $794.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $446.68 Median $1,445.44 Typical High $4,265.80 | Facility | None | $446.68 | $1,445.44 | $4,265.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $281.84 Median $630.96 Typical High $3,162.28 | Professional | None | $281.84 | $630.96 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,413.10 | Facility | None | $1,047.13 | $2,344.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $288.40 Median $537.03 Typical High $1,071.52 | Professional | None | $288.40 | $537.03 | $1,071.52 |
Well Sense Setting Facility Modifier None Typical Low $295.12 Median $549.54 Typical High $831.76 | Facility | None | $295.12 | $549.54 | $831.76 |
Well Sense Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $758.58 | Professional | None | $251.19 | $302.00 | $758.58 |
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 $117.49 Median $204.17 Typical High $363.08 | Professional | 52 · Reduced service | $117.49 | $204.17 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $81.28 Typical High $144.54 | Professional | 53 · Discontinued | $46.77 | $81.28 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $302.00 Typical High $549.54 | Professional | 54 · Surgery only | $173.78 | $302.00 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $60.26 Typical High $109.65 | Professional | 55 · Aftercare only | $34.67 | $60.26 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $40.74 Typical High $72.44 | Professional | 56 · Pre-op care only | $23.44 | $40.74 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $281.84 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $162.18 | $281.84 | $512.86 |
Where Massachusetts sits
The same service costs 4.6 times more in Alaska 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· 17th of 51
$501
AK $1,259UT $275
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.