How much rates vary
Facilitymedian $724 · 10th to 90th $316 to $3,981Professionalmedian $676 · 10th to 90th $347 to $1,698
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 $870.96 Median $2,187.76 Typical High $3,630.78 | Facility | None | $870.96 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $870.96 | Professional | None | $346.74 | $398.11 | $870.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $416.87 Median $1,445.44 Typical High $4,365.16 | Facility | None | $416.87 | $1,445.44 | $4,365.16 |
AllWays Health Partners Setting Professional Modifier None Typical Low $338.84 Median $812.83 Typical High $3,311.31 | Professional | None | $338.84 | $812.83 | $3,311.31 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $794.33 | Facility | None | $346.74 | $346.74 | $794.33 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $912.01 | Professional | None | $346.74 | $524.81 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $562.34 Typical High $831.76 | Facility | None | $100.00 | $562.34 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $676.08 Typical High $1,202.26 | Professional | None | $281.84 | $676.08 | $1,202.26 |
Fallon Health Setting Facility Modifier None Typical Low $338.84 Median $446.68 Typical High $3,311.31 | Facility | None | $338.84 | $446.68 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $912.01 | Professional | None | $549.54 | $660.69 | $912.01 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $363.08 Median $794.33 Typical High $1,258.93 | Professional | None | $363.08 | $794.33 | $1,258.93 |
Mass General Brigham Setting Facility Modifier None Typical Low $416.87 Median $1,445.44 Typical High $4,365.16 | Facility | None | $416.87 | $1,445.44 | $4,365.16 |
Mass General Brigham Setting Professional Modifier None Typical Low $338.84 Median $812.83 Typical High $3,311.31 | Professional | None | $338.84 | $812.83 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,762.47 | Facility | None | $1,047.13 | $2,344.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $1,288.25 | Professional | None | $363.08 | $549.54 | $1,288.25 |
Well Sense Setting Facility Modifier None Typical Low $218.78 Median $371.54 Typical High $602.56 | Facility | None | $218.78 | $371.54 | $602.56 |
Well Sense Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $323.59 | Professional | None | $234.42 | $269.15 | $323.59 |
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 $173.78 Median $199.53 Typical High $436.52 | Professional | 52 · Reduced service | $173.78 | $199.53 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $79.43 Typical High $173.78 | Professional | 53 · Discontinued | $69.18 | $79.43 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $645.65 | Professional | 54 · Surgery only | $257.04 | $302.00 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $60.26 Typical High $131.83 | Professional | 55 · Aftercare only | $52.48 | $60.26 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $39.81 Typical High $87.10 | Professional | 56 · Pre-op care only | $34.67 | $39.81 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $281.84 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $245.47 | $281.84 | $616.60 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $173.78 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $147.91 | $173.78 | $208.93 |
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· 10th of 51
$676
AK $1,380UT $275
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.