How much rates vary
Facilitymedian $537 · 10th to 90th $245 to $3,388Professionalmedian $617 · 10th to 90th $316 to $2,754
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 $1,174.90 Median $2,818.38 Typical High $5,128.61 | Facility | None | $1,174.90 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $812.83 | Professional | None | $331.13 | $331.13 | $812.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $316.23 Median $776.25 Typical High $3,548.13 | Facility | None | $316.23 | $776.25 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $436.52 Median $1,148.15 Typical High $2,754.23 | Professional | None | $436.52 | $1,148.15 | $2,754.23 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $426.58 Median $851.14 Typical High $1,412.54 | Professional | None | $426.58 | $851.14 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $446.68 Typical High $954.99 | Facility | None | $50.12 | $446.68 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,148.15 | Professional | None | $478.63 | $478.63 | $1,148.15 |
Fallon Health Setting Facility Modifier None Typical Low $245.47 Median $467.74 Typical High $1,412.54 | Facility | None | $245.47 | $467.74 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $234.42 Median $416.87 Typical High $616.60 | Professional | None | $234.42 | $416.87 | $616.60 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $467.74 Median $851.14 Typical High $1,230.27 | Professional | None | $467.74 | $851.14 | $1,230.27 |
Mass General Brigham Setting Facility Modifier None Typical Low $316.23 Median $776.25 Typical High $3,548.13 | Facility | None | $316.23 | $776.25 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $436.52 Median $1,148.15 Typical High $2,754.23 | Professional | None | $436.52 | $1,148.15 | $2,754.23 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $1,479.11 | Professional | None | $457.09 | $616.60 | $1,479.11 |
Well Sense Setting Facility Modifier None Typical Low $316.23 Median $426.58 Typical High $645.65 | Facility | None | $316.23 | $426.58 | $645.65 |
Well Sense Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | None | $295.12 | $295.12 | $354.81 |
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 $165.96 Median $165.96 Typical High $588.84 | Professional | 52 · Reduced service | $165.96 | $165.96 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $234.42 | Professional | 53 · Discontinued | $66.07 | $66.07 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $891.25 | Professional | 54 · Surgery only | $251.19 | $251.19 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $177.83 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $117.49 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $831.76 |
Where Massachusetts sits
The same service costs 5.0 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· 24th of 51
$603
AK $1,349UT $269
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.