How much rates vary
Facilitymedian $479 · 10th to 90th $288 to $2,754Professionalmedian $525 · 10th to 90th $309 to $1,259
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 $794.33 Median $2,691.53 Typical High $3,715.35 | Facility | None | $794.33 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $724.44 | Professional | None | $316.23 | $338.84 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $234.42 Typical High $257.04 | Professional | 54 · Surgery only | $218.78 | $234.42 | $257.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $2,454.71 | Facility | None | $354.81 | $660.69 | $2,454.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $309.03 Median $758.58 Typical High $2,511.89 | Professional | None | $309.03 | $758.58 | $2,511.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $323.59 Median $389.05 Typical High $724.44 | Facility | None | $323.59 | $389.05 | $724.44 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $724.44 | Professional | None | $323.59 | $398.11 | $724.44 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $389.05 Typical High $512.86 | Professional | 54 · Surgery only | $223.87 | $389.05 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $776.25 | Facility | None | $457.09 | $588.84 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $512.86 Typical High $1,122.02 | Professional | None | $269.15 | $512.86 | $1,122.02 |
Fallon Health Setting Facility Modifier None Typical Low $316.23 Median $407.38 Typical High $3,311.31 | Facility | None | $316.23 | $407.38 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $691.83 | Professional | None | $416.87 | $501.19 | $691.83 |
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 $331.13 Median $691.83 Typical High $1,047.13 | Professional | None | $331.13 | $691.83 | $1,047.13 |
Health New England Setting Facility Modifier None Typical Low $295.12 Median $316.23 Typical High $3,890.45 | Facility | None | $295.12 | $316.23 | $3,890.45 |
Health New England Setting Professional Modifier None Typical Low $257.04 Median $467.74 Typical High $602.56 | Professional | None | $257.04 | $467.74 | $602.56 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $2,454.71 | Facility | None | $354.81 | $660.69 | $2,454.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $309.03 Median $758.58 Typical High $2,511.89 | Professional | None | $309.03 | $758.58 | $2,511.89 |
Tufts Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $630.96 | Professional | None | $158.49 | $295.12 | $630.96 |
United Setting Facility Modifier None Typical Low $407.38 Median $851.14 Typical High $4,168.69 | Facility | None | $407.38 | $851.14 | $4,168.69 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $1,174.90 | Professional | None | $323.59 | $446.68 | $1,174.90 |
Well Sense Setting Facility Modifier None Typical Low $218.78 Median $316.23 Typical High $537.03 | Facility | None | $218.78 | $316.23 | $537.03 |
Well Sense Setting Professional Modifier None Typical Low $213.80 Median $223.87 Typical High $269.15 | Professional | None | $213.80 | $223.87 | $269.15 |
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 $158.49 Median $165.96 Typical High $398.11 | Professional | 52 · Reduced service | $158.49 | $165.96 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $67.61 Typical High $158.49 | Professional | 53 · Discontinued | $63.10 | $67.61 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $50.12 Typical High $120.23 | Professional | 55 · Aftercare only | $47.86 | $50.12 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.88 Typical High $79.43 | Professional | 56 · Pre-op care only | $31.62 | $33.88 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $218.78 | $234.42 | $234.42 |
BCBS Massachusetts Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $131.83 Typical High $177.83 | Professional | 55 · Aftercare only | $79.43 | $131.83 | $177.83 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $426.58 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $257.04 | $426.58 | $562.34 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $134.90 | $144.54 | $173.78 |
Where Massachusetts sits
The same service costs 5.8 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· 11th of 51
$513
AK $1,259UT $219
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.