How much rates vary
Facilitymedian $490 · 10th to 90th $135 to $3,890Professionalmedian $324 · 10th to 90th $182 to $3,162
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $416.87 | Professional | None | $177.83 | $199.53 | $416.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $371.54 Median $1,698.24 Typical High $4,897.79 | Facility | None | $371.54 | $1,698.24 | $4,897.79 |
AllWays Health Partners Setting Professional Modifier None Typical Low $199.53 Median $446.68 Typical High $3,162.28 | Professional | None | $199.53 | $446.68 | $3,162.28 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $426.58 | Facility | None | $186.21 | $229.09 | $426.58 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $794.33 | Professional | None | $245.47 | $398.11 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,187.76 Typical High $3,311.31 | Facility | None | $446.68 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $645.65 | Professional | None | $218.78 | $295.12 | $645.65 |
Fallon Health Setting Facility Modifier None Typical Low $107.15 Median $213.80 Typical High $1,412.54 | Facility | None | $107.15 | $213.80 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $154.88 Median $275.42 Typical High $398.11 | Professional | None | $154.88 | $275.42 | $398.11 |
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 $199.53 Median $398.11 Typical High $741.31 | Professional | None | $199.53 | $398.11 | $741.31 |
Health New England Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $5,011.87 | Facility | None | $1,949.84 | $1,949.84 | $5,011.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $371.54 Median $1,698.24 Typical High $4,897.79 | Facility | None | $371.54 | $1,698.24 | $4,897.79 |
Mass General Brigham Setting Professional Modifier None Typical Low $199.53 Median $446.68 Typical High $3,162.28 | Professional | None | $199.53 | $446.68 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $851.14 | Professional | None | $218.78 | $309.03 | $851.14 |
Well Sense Setting Facility Modifier None Typical Low $169.82 Median $263.03 Typical High $1,047.13 | Facility | None | $169.82 | $263.03 | $1,047.13 |
Well Sense Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $169.82 | Professional | None | $125.89 | $141.25 | $169.82 |
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 $89.13 Median $100.00 Typical High $245.47 | Professional | 52 · Reduced service | $89.13 | $100.00 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $39.81 Typical High $97.72 | Professional | 53 · Discontinued | $35.48 | $39.81 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $151.36 Typical High $371.54 | Professional | 54 · Surgery only | $134.90 | $151.36 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $74.13 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.95 Typical High $48.98 | Professional | 56 · Pre-op care only | $17.78 | $19.95 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $141.25 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $125.89 | $141.25 | $346.74 |
Where Massachusetts sits
The same service costs 4.4 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· 15th of 51
$339
AK $871UT $200
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.