How much rates vary
Facilitymedian $603 · 10th to 90th $324 to $2,951Professionalmedian $851 · 10th to 90th $501 to $1,995
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 $1,737.80 Median $3,090.30 Typical High $6,309.57 | Facility | None | $1,737.80 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $1,348.96 | Professional | None | $501.19 | $524.81 | $1,348.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $616.60 Typical High $1,949.84 | Facility | None | $323.59 | $616.60 | $1,949.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $562.34 Median $1,148.15 Typical High $3,890.45 | Professional | None | $562.34 | $1,148.15 | $3,890.45 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $1,122.02 | Facility | None | $489.78 | $602.56 | $1,122.02 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $1,122.02 | Professional | None | $489.78 | $602.56 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $489.78 Typical High $630.96 | Facility | None | $199.53 | $489.78 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,737.80 | Professional | None | $562.34 | $794.33 | $1,737.80 |
Fallon Health Setting Facility Modifier None Typical Low $489.78 Median $630.96 Typical High $3,311.31 | Facility | None | $489.78 | $630.96 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,047.13 | Professional | None | $645.65 | $776.25 | $1,047.13 |
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 $549.54 Median $1,071.52 Typical High $1,584.89 | Professional | None | $549.54 | $1,071.52 | $1,584.89 |
Health New England Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $831.76 | Professional | None | $724.44 | $741.31 | $831.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $616.60 Typical High $1,949.84 | Facility | None | $323.59 | $616.60 | $1,949.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $562.34 Median $1,148.15 Typical High $3,890.45 | Professional | None | $562.34 | $1,148.15 | $3,890.45 |
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 $549.54 Median $812.83 Typical High $1,862.09 | Professional | None | $549.54 | $812.83 | $1,862.09 |
Well Sense Setting Facility Modifier None Typical Low $218.78 Median $489.78 Typical High $851.14 | Facility | None | $218.78 | $489.78 | $851.14 |
Well Sense Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $575.44 | Professional | None | $457.09 | $478.63 | $575.44 |
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 $251.19 Median $263.03 Typical High $851.14 | Professional | 52 · Reduced service | $251.19 | $263.03 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $346.74 | Professional | 53 · Discontinued | $100.00 | $104.71 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $389.05 Typical High $1,288.25 | Professional | 54 · Surgery only | $380.19 | $389.05 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $257.04 | Professional | 55 · Aftercare only | $75.86 | $77.62 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $173.78 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $363.08 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $354.81 | $363.08 | $1,202.26 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $489.78 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $398.11 | $489.78 | $851.14 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $302.00 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $295.12 | $302.00 | $363.08 |
Where Massachusetts sits
The same service costs 6.2 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
$832
AK $1,995UT $324
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.