How much rates vary
Facilitymedian $912 · 10th to 90th $263 to $4,571Professionalmedian $575 · 10th to 90th $309 to $3,020
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 $3,090.30 Typical High $6,309.57 | Facility | None | $1,000.00 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $891.25 | Professional | None | $288.40 | $309.03 | $891.25 |
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 $380.19 Median $891.25 Typical High $3,019.95 | Professional | None | $380.19 | $891.25 | $3,019.95 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $371.54 Median $446.68 Typical High $851.14 | Facility | None | $371.54 | $446.68 | $851.14 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $371.54 Median $630.96 Typical High $1,258.93 | Professional | None | $371.54 | $630.96 | $1,258.93 |
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 $426.58 Median $489.78 Typical High $1,071.52 | Professional | None | $426.58 | $489.78 | $1,071.52 |
Fallon Health Setting Facility Modifier None Typical Low $213.80 Median $426.58 Typical High $1,905.46 | Facility | None | $213.80 | $426.58 | $1,905.46 |
Fallon Health Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $676.08 | Professional | None | $263.03 | $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 $407.38 Median $794.33 Typical High $1,258.93 | Professional | None | $407.38 | $794.33 | $1,258.93 |
Health New England Setting Facility Modifier None Typical Low $3,388.44 Median $4,677.35 Typical High $5,248.07 | Facility | None | $3,388.44 | $4,677.35 | $5,248.07 |
Health New England Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $380.19 Median $891.25 Typical High $3,019.95 | Professional | None | $380.19 | $891.25 | $3,019.95 |
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 $575.44 Typical High $1,258.93 | Professional | None | $416.87 | $575.44 | $1,258.93 |
Well Sense Setting Facility Modifier None Typical Low $323.59 Median $549.54 Typical High $1,047.13 | Facility | None | $323.59 | $549.54 | $1,047.13 |
Well Sense Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $331.13 | Professional | None | $257.04 | $275.42 | $331.13 |
12 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 $61.66 Typical High $199.53 | Professional | 53 · Discontinued | $57.54 | $61.66 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $229.09 Typical High $758.58 | Professional | 54 · Surgery only | $218.78 | $229.09 | $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 $213.80 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $204.17 | $213.80 | $707.95 |
AllWays Health Partners Setting Professional Modifier TF · Intermediate care level Typical Low $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | TF · Intermediate care level | $1,174.90 | $1,174.90 | $1,584.89 |
AllWays Health Partners Setting Professional Modifier TG · Complex care level Typical Low $1,258.93 Median $1,258.93 Typical High $1,698.24 | Professional | TG · Complex care level | $1,258.93 | $1,258.93 | $1,698.24 |
Mass General Brigham Setting Professional Modifier TF · Intermediate care level Typical Low $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | TF · Intermediate care level | $1,174.90 | $1,174.90 | $1,584.89 |
Mass General Brigham Setting Professional Modifier TG · Complex care level Typical Low $1,258.93 Median $1,258.93 Typical High $1,698.24 | Professional | TG · Complex care level | $1,258.93 | $1,258.93 | $1,698.24 |
Well Sense Setting Facility Modifier TF · Intermediate care level Typical Low $588.84 Median $758.58 Typical High $1,380.38 | Facility | TF · Intermediate care level | $588.84 | $758.58 | $1,380.38 |
Well Sense Setting Facility Modifier TG · Complex care level Typical Low $831.76 Median $1,071.52 Typical High $1,949.84 | Facility | TG · Complex care level | $831.76 | $1,071.52 | $1,949.84 |
Where Massachusetts sits
The same service costs 3.8 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
$603
AK $1,349UT $355
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.