How much rates vary
Facilitymedian $170 · 10th to 90th $87 to $2,042Professionalmedian $178 · 10th to 90th $102 to $468
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 $114.82 Median $2,691.53 Typical High $5,128.61 | Facility | None | $114.82 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $269.15 | Professional | None | $102.33 | $114.82 | $269.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $72.44 Median $380.19 Typical High $1,862.09 | Facility | None | $72.44 | $380.19 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $102.33 Median $229.09 Typical High $2,290.87 | Professional | None | $102.33 | $229.09 | $2,290.87 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $223.87 | Facility | None | $97.72 | $97.72 | $223.87 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $234.42 | Professional | None | $97.72 | $134.90 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $100.00 | Facility | None | $50.12 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $177.83 Typical High $354.81 | Professional | None | $91.20 | $177.83 | $354.81 |
Fallon Health Setting Facility Modifier None Typical Low $89.13 Median $123.03 Typical High $3,311.31 | Facility | None | $89.13 | $123.03 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $234.42 | Professional | None | $120.23 | $154.88 | $234.42 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $114.82 Median $223.87 Typical High $354.81 | Professional | None | $114.82 | $223.87 | $354.81 |
Mass General Brigham Setting Facility Modifier None Typical Low $72.44 Median $380.19 Typical High $1,862.09 | Facility | None | $72.44 | $380.19 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $102.33 Median $229.09 Typical High $2,290.87 | Professional | None | $102.33 | $229.09 | $2,290.87 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $380.19 | Professional | None | $112.20 | $154.88 | $380.19 |
Well Sense Setting Facility Modifier None Typical Low $75.86 Median $109.65 Typical High $173.78 | Facility | None | $75.86 | $109.65 | $173.78 |
Well Sense Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $95.50 | Professional | None | $72.44 | $79.43 | $95.50 |
7 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 $51.29 Median $57.54 Typical High $134.90 | Professional | 52 · Reduced service | $51.29 | $57.54 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.91 Typical High $54.95 | Professional | 53 · Discontinued | $20.42 | $22.91 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $87.10 Typical High $204.17 | Professional | 54 · Surgery only | $77.62 | $87.10 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.38 Typical High $40.74 | Professional | 55 · Aftercare only | $15.49 | $17.38 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.48 Typical High $26.92 | Professional | 56 · Pre-op care only | $10.23 | $11.48 | $26.92 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $97.72 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $77.62 | $97.72 | $169.82 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $45.71 Median $51.29 Typical High $61.66 | Professional | 78 · Unplanned return to OR | $45.71 | $51.29 | $61.66 |
Where Massachusetts sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 11th of 51
$178
AK $407FL $91.20
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.