How much rates vary
Facilitymedian $1,820 · 10th to 90th $708 to $5,888Professionalmedian $1,698 · 10th to 90th $813 to $6,166
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 $2,089.30 Median $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,137.96 | Professional | None | $812.83 | $812.83 | $2,137.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $575.44 Median $2,290.87 Typical High $6,456.54 | Facility | None | $575.44 | $2,290.87 | $6,456.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $933.25 Median $2,398.83 Typical High $6,165.95 | Professional | None | $933.25 | $2,398.83 | $6,165.95 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $2,187.76 | Professional | None | $691.83 | $691.83 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,290.87 Typical High $3,311.31 | Facility | None | $676.08 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,445.44 Typical High $3,311.31 | Professional | None | $724.44 | $1,445.44 | $3,311.31 |
Fallon Health Setting Facility Modifier None Typical Low $870.96 Median $1,202.26 Typical High $3,311.31 | Facility | None | $870.96 | $1,202.26 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,230.27 | $1,698.24 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $977.24 Median $1,905.46 Typical High $2,754.23 | Professional | None | $977.24 | $1,905.46 | $2,754.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $575.44 Median $2,290.87 Typical High $6,456.54 | Facility | None | $575.44 | $2,290.87 | $6,456.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $933.25 Median $2,398.83 Typical High $6,165.95 | Professional | None | $933.25 | $2,398.83 | $6,165.95 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $10,471.29 | Facility | None | $851.14 | $2,818.38 | $10,471.29 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $3,235.94 | Professional | None | $870.96 | $1,202.26 | $3,235.94 |
Well Sense Setting Facility Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,479.11 | Facility | None | $707.95 | $1,071.52 | $1,479.11 |
Well Sense Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | None | $562.34 | $562.34 | $676.08 |
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 $407.38 Median $407.38 Typical High $1,047.13 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $426.58 | Professional | 53 · Discontinued | $162.18 | $162.18 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $1,584.89 | Professional | 54 · Surgery only | $616.60 | $616.60 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $316.23 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $213.80 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,479.11 |
Where Massachusetts sits
The same service costs 8.1 times more in Wyoming 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· 12th of 51
$1,698
WY $4,169UT $513
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.