How much rates vary
Facilitymedian $501 · 10th to 90th $145 to $3,311Professionalmedian $355 · 10th to 90th $145 to $1,122
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 $691.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $691.83 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $275.42 Typical High $363.08 | Professional | None | $138.04 | $275.42 | $363.08 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,000.00 Typical High $3,548.13 | Facility | None | $346.74 | $1,000.00 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $173.78 Median $416.87 Typical High $2,951.21 | Professional | None | $173.78 | $416.87 | $2,951.21 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $316.23 | Facility | None | $138.04 | $165.96 | $316.23 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $138.04 Median $323.59 Typical High $562.34 | Professional | None | $138.04 | $323.59 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $831.76 Typical High $1,047.13 | Facility | None | $588.84 | $831.76 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $316.23 Typical High $676.08 | Professional | None | $128.82 | $316.23 | $676.08 |
Fallon Health Setting Facility Modifier None Typical Low $134.90 Median $177.83 Typical High $3,311.31 | Facility | None | $134.90 | $177.83 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $562.34 | Professional | None | $338.84 | $407.38 | $562.34 |
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 $169.82 Median $338.84 Typical High $776.25 | Professional | None | $169.82 | $338.84 | $776.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,000.00 Typical High $3,548.13 | Facility | None | $346.74 | $1,000.00 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $173.78 Median $416.87 Typical High $2,951.21 | Professional | None | $173.78 | $416.87 | $2,951.21 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $5,128.61 | Facility | None | $575.44 | $1,380.38 | $5,128.61 |
United Setting Professional Modifier None Typical Low $169.82 Median $363.08 Typical High $776.25 | Professional | None | $169.82 | $363.08 | $776.25 |
Well Sense Setting Facility Modifier None Typical Low $123.03 Median $239.88 Typical High $416.87 | Facility | None | $123.03 | $239.88 | $416.87 |
Well Sense Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $229.09 | Professional | None | $95.50 | $131.83 | $229.09 |
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 $69.18 Median $138.04 Typical High $177.83 | Professional | 52 · Reduced service | $69.18 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $54.95 Typical High $72.44 | Professional | 53 · Discontinued | $27.54 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $208.93 Typical High $269.15 | Professional | 54 · Surgery only | $104.71 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $41.69 Typical High $53.70 | Professional | 55 · Aftercare only | $20.89 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $27.54 Typical High $36.31 | Professional | 56 · Pre-op care only | $13.80 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $194.98 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $97.72 | $194.98 | $251.19 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $83.18 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $61.66 | $83.18 | $144.54 |
Where Massachusetts sits
The same service costs 4.7 times more in Alaska than in Virginia. 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
$363
AK $851VA $182
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.