How much rates vary
Facilitymedian $126 · 10th to 90th $43 to $2,512Professionalmedian $115 · 10th to 90th $59 to $347
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 $426.58 Median $2,187.76 Typical High $3,630.78 | Facility | None | $426.58 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $239.88 | Professional | None | $85.11 | $144.54 | $239.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $95.50 Median $676.08 Typical High $2,089.30 | Facility | None | $95.50 | $676.08 | $2,089.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $50.12 Median $123.03 Typical High $1,023.29 | Professional | None | $50.12 | $123.03 | $1,023.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $100.00 | Facility | None | $42.66 | $42.66 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $489.78 | Facility | None | $70.79 | $100.00 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $114.82 Typical High $204.17 | Professional | None | $60.26 | $114.82 | $204.17 |
Fallon Health Setting Facility Modifier None Typical Low $43.65 Median $56.23 Typical High $3,311.31 | Facility | None | $43.65 | $56.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $128.82 | Professional | None | $97.72 | $112.20 | $128.82 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $56.23 Median $109.65 Typical High $234.42 | Professional | None | $56.23 | $109.65 | $234.42 |
Health New England Setting Facility Modifier None Typical Low $691.83 Median $741.31 Typical High $776.25 | Facility | None | $691.83 | $741.31 | $776.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $95.50 Median $676.08 Typical High $2,089.30 | Facility | None | $95.50 | $676.08 | $2,089.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $50.12 Median $123.03 Typical High $1,023.29 | Professional | None | $50.12 | $123.03 | $1,023.29 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $58.88 Median $120.23 Typical High $251.19 | Professional | None | $58.88 | $120.23 | $251.19 |
Well Sense Setting Facility Modifier None Typical Low $38.02 Median $63.10 Typical High $95.50 | Facility | None | $38.02 | $63.10 | $95.50 |
Well Sense Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $125.89 | Professional | None | $60.26 | $81.28 | $125.89 |
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 $42.66 Median $72.44 Typical High $117.49 | Professional | 52 · Reduced service | $42.66 | $72.44 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $28.84 Typical High $47.86 | Professional | 53 · Discontinued | $17.38 | $28.84 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $109.65 Typical High $177.83 | Professional | 54 · Surgery only | $64.57 | $109.65 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $21.88 Typical High $35.48 | Professional | 55 · Aftercare only | $12.88 | $21.88 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.45 Typical High $23.99 | Professional | 56 · Pre-op care only | $8.71 | $14.45 | $23.99 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $58.88 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $38.90 | $58.88 | $91.20 |
Where Massachusetts sits
The same service costs 3.2 times more in Alaska than in Virginia. 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· 13th of 51
$115
AK $191VA $60.26
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.