How much rates vary
Facilitymedian $912 · 10th to 90th $275 to $4,266Professionalmedian $589 · 10th to 90th $309 to $3,090
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 $309.03 Median $2,951.21 Typical High $5,754.40 | Facility | None | $309.03 | $2,951.21 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $851.14 | Professional | None | $288.40 | $309.03 | $851.14 |
AllWays Health Partners Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $4,897.79 | Facility | None | $691.83 | $1,737.80 | $4,897.79 |
AllWays Health Partners Setting Professional Modifier None Typical Low $416.87 Median $912.01 Typical High $3,090.30 | Professional | None | $416.87 | $912.01 | $3,090.30 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $380.19 Median $467.74 Typical High $870.96 | Facility | None | $380.19 | $467.74 | $870.96 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $489.78 Median $851.14 Typical High $1,479.11 | Professional | None | $489.78 | $851.14 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,290.87 Typical High $3,388.44 | Facility | None | $588.84 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $1,096.48 | Professional | None | $436.52 | $501.19 | $1,096.48 |
Fallon Health Setting Facility Modifier None Typical Low $218.78 Median $436.52 Typical High $1,905.46 | Facility | None | $218.78 | $436.52 | $1,905.46 |
Fallon Health Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $691.83 | Professional | None | $269.15 | $478.63 | $691.83 |
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 $416.87 Median $812.83 Typical High $1,288.25 | Professional | None | $416.87 | $812.83 | $1,288.25 |
Health New England Setting Facility Modifier None Typical Low $3,548.13 Median $5,128.61 Typical High $5,248.07 | Facility | None | $3,548.13 | $5,128.61 | $5,248.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $4,897.79 | Facility | None | $691.83 | $1,737.80 | $4,897.79 |
Mass General Brigham Setting Professional Modifier None Typical Low $416.87 Median $912.01 Typical High $3,090.30 | Professional | None | $416.87 | $912.01 | $3,090.30 |
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 $416.87 Median $562.34 Typical High $1,288.25 | Professional | None | $416.87 | $562.34 | $1,288.25 |
Well Sense Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $1,047.13 | Facility | None | $467.74 | $645.65 | $1,047.13 |
Well Sense Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $501.19 | Professional | None | $380.19 | $416.87 | $501.19 |
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 $144.54 Median $154.88 Typical High $501.19 | Professional | 52 · Reduced service | $144.54 | $154.88 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $63.10 Typical High $199.53 | Professional | 53 · Discontinued | $57.54 | $63.10 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $234.42 Typical High $758.58 | Professional | 54 · Surgery only | $218.78 | $234.42 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $46.77 Typical High $151.36 | Professional | 55 · Aftercare only | $43.65 | $46.77 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.90 Typical High $100.00 | Professional | 56 · Pre-op care only | $28.84 | $30.90 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $218.78 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $204.17 | $218.78 | $707.95 |
Where Massachusetts sits
The same service costs 4.3 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· 16th of 51
$617
AK $1,380UT $324
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.