How much rates vary
Facilitymedian $603 · 10th to 90th $117 to $3,631Professionalmedian $245 · 10th to 90th $117 to $676
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 $446.68 Median $2,187.76 Typical High $3,630.78 | Facility | None | $446.68 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $288.40 | Professional | None | $112.20 | $169.82 | $288.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $4,265.80 | Facility | None | $323.59 | $1,258.93 | $4,265.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $131.83 Median $281.84 Typical High $1,318.26 | Professional | None | $131.83 | $281.84 | $1,318.26 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $257.04 | Facility | None | $112.20 | $138.04 | $257.04 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $363.08 | Professional | None | $112.20 | $213.80 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,398.83 | Facility | None | $446.68 | $1,659.59 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $263.03 Typical High $436.52 | Professional | None | $104.71 | $263.03 | $436.52 |
Fallon Health Setting Facility Modifier None Typical Low $109.65 Median $147.91 Typical High $3,311.31 | Facility | None | $109.65 | $147.91 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $371.54 | Professional | None | $218.78 | $269.15 | $371.54 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $131.83 Median $257.04 Typical High $512.86 | Professional | None | $131.83 | $257.04 | $512.86 |
Health New England Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $257.04 | Professional | None | $144.54 | $257.04 | $257.04 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $4,265.80 | Facility | None | $323.59 | $1,258.93 | $4,265.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $131.83 Median $281.84 Typical High $1,318.26 | Professional | None | $131.83 | $281.84 | $1,318.26 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $7,585.78 | Facility | None | $575.44 | $1,380.38 | $7,585.78 |
United Setting Professional Modifier None Typical Low $131.83 Median $234.42 Typical High $512.86 | Professional | None | $131.83 | $234.42 | $512.86 |
Well Sense Setting Facility Modifier None Typical Low $100.00 Median $177.83 Typical High $851.14 | Facility | None | $100.00 | $177.83 | $851.14 |
Well Sense Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $138.04 | Professional | None | $75.86 | $102.33 | $138.04 |
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 $56.23 Median $85.11 Typical High $144.54 | Professional | 52 · Reduced service | $56.23 | $85.11 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $33.88 Typical High $57.54 | Professional | 53 · Discontinued | $22.39 | $33.88 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $128.82 Typical High $213.80 | Professional | 54 · Surgery only | $83.18 | $128.82 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $25.70 Typical High $43.65 | Professional | 55 · Aftercare only | $16.98 | $25.70 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $16.98 Typical High $28.84 | Professional | 56 · Pre-op care only | $11.22 | $16.98 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $120.23 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $77.62 | $120.23 | $199.53 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $112.20 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $91.20 | $112.20 | $169.82 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $66.07 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $48.98 | $66.07 | $89.13 |
Where Massachusetts sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 9th of 51
$251
AK $603KY $126
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.