How much rates vary
Facilitymedian $407 · 10th to 90th $245 to $3,090Professionalmedian $631 · 10th to 90th $324 to $1,202
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 $1,659.59 Median $3,090.30 Typical High $6,309.57 | Facility | None | $1,659.59 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,122.02 | Professional | None | $501.19 | $724.44 | $1,122.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $295.12 Median $616.60 Typical High $1,949.84 | Facility | None | $295.12 | $616.60 | $1,949.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $316.23 Median $724.44 Typical High $4,677.35 | Professional | None | $316.23 | $724.44 | $4,677.35 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $275.42 Median $331.13 Typical High $630.96 | Facility | None | $275.42 | $331.13 | $630.96 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $616.60 | Professional | None | $275.42 | $407.38 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $338.84 Typical High $489.78 | Facility | None | $199.53 | $338.84 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $977.24 | Professional | None | $416.87 | $549.54 | $977.24 |
Fallon Health Setting Facility Modifier None Typical Low $269.15 Median $354.81 Typical High $3,311.31 | Facility | None | $269.15 | $354.81 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $616.60 | Professional | None | $371.54 | $446.68 | $616.60 |
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 $323.59 Median $645.65 Typical High $933.25 | Professional | None | $323.59 | $645.65 | $933.25 |
Health New England Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Health New England Setting Professional Modifier None Typical Low $416.87 Median $426.58 Typical High $489.78 | Professional | None | $416.87 | $426.58 | $489.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $295.12 Median $616.60 Typical High $1,949.84 | Facility | None | $295.12 | $616.60 | $1,949.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $316.23 Median $724.44 Typical High $4,677.35 | Professional | None | $316.23 | $724.44 | $4,677.35 |
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 $331.13 Median $602.56 Typical High $1,023.29 | Professional | None | $331.13 | $602.56 | $1,023.29 |
Well Sense Setting Facility Modifier None Typical Low $144.54 Median $275.42 Typical High $478.63 | Facility | None | $144.54 | $275.42 | $478.63 |
Well Sense Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $588.84 | Professional | None | $446.68 | $489.78 | $588.84 |
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 $323.59 Median $363.08 Typical High $831.76 | Professional | 52 · Reduced service | $323.59 | $363.08 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $144.54 Typical High $331.13 | Professional | 53 · Discontinued | $128.82 | $144.54 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $549.54 Typical High $1,230.27 | Professional | 54 · Surgery only | $478.63 | $549.54 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $109.65 Typical High $245.47 | Professional | 55 · Aftercare only | $97.72 | $109.65 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $165.96 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $512.86 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $446.68 | $512.86 | $1,148.15 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $371.54 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $218.78 | $371.54 | $562.34 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $316.23 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $281.84 | $316.23 | $380.19 |
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· 9th of 51
$631
AK $1,096UT $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.