How much rates vary
Facilitymedian $132 · 10th to 90th $43 to $2,455Professionalmedian $105 · 10th to 90th $48 to $257
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 $74.13 Median $1,819.70 Typical High $3,388.44 | Facility | None | $74.13 | $1,819.70 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $87.10 Typical High $199.53 | Professional | None | $47.86 | $87.10 | $199.53 |
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 $57.54 Median $117.49 Typical High $1,348.96 | Professional | None | $57.54 | $117.49 | $1,348.96 |
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 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $42.66 Median $95.50 Typical High $165.96 | Professional | None | $42.66 | $95.50 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $489.78 | Facility | None | $81.28 | $102.33 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $107.15 Typical High $190.55 | Professional | None | $57.54 | $107.15 | $190.55 |
Fallon Health Setting Facility Modifier None Typical Low $42.66 Median $56.23 Typical High $3,311.31 | Facility | None | $42.66 | $56.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $141.25 | Professional | None | $104.71 | $123.03 | $141.25 |
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 $54.95 Median $107.15 Typical High $229.09 | Professional | None | $54.95 | $107.15 | $229.09 |
Health New England Setting Facility Modifier None Typical Low $190.55 Median $501.19 Typical High $1,318.26 | Facility | None | $190.55 | $501.19 | $1,318.26 |
Health New England Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $177.83 | Professional | None | $60.26 | $87.10 | $177.83 |
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 $57.54 Median $117.49 Typical High $1,348.96 | Professional | None | $57.54 | $117.49 | $1,348.96 |
Tufts Setting Facility Modifier None Typical Low $15.49 Median $371.54 Typical High $741.31 | Facility | None | $15.49 | $371.54 | $741.31 |
Tufts Setting Professional Modifier None Typical Low $15.49 Median $52.48 Typical High $131.83 | Professional | None | $15.49 | $52.48 | $131.83 |
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 $57.54 Median $109.65 Typical High $218.78 | Professional | None | $57.54 | $109.65 | $218.78 |
Well Sense Setting Facility Modifier None Typical Low $37.15 Median $53.70 Typical High $87.10 | Facility | None | $37.15 | $53.70 | $87.10 |
Well Sense Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $89.13 | Professional | None | $50.12 | $67.61 | $89.13 |
8 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 $23.99 Median $43.65 Typical High $100.00 | Professional | 52 · Reduced service | $23.99 | $43.65 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $17.38 Typical High $40.74 | Professional | 53 · Discontinued | $9.55 | $17.38 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $64.57 Typical High $151.36 | Professional | 54 · Surgery only | $35.48 | $64.57 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.88 Typical High $30.20 | Professional | 55 · Aftercare only | $7.08 | $12.88 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $8.71 Typical High $19.95 | Professional | 56 · Pre-op care only | $4.79 | $8.71 | $19.95 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $18.62 Typical High $45.71 | Professional | 53 · Discontinued | $13.80 | $18.62 | $45.71 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $34.67 Median $58.88 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $34.67 | $58.88 | $131.83 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $32.36 Median $47.86 Typical High $64.57 | Professional | 78 · Unplanned return to OR | $32.36 | $47.86 | $64.57 |
Where Massachusetts sits
The same service costs 3.5 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
$105
AK $204VA $58.88
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.