How much rates vary
Facilitymedian $1,000 · 10th to 90th $437 to $4,169Professionalmedian $871 · 10th to 90th $457 to $4,898
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 $1,230.27 Median $2,818.38 Typical High $5,248.07 | Facility | None | $1,230.27 | $2,818.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $1,148.15 | Professional | None | $436.52 | $549.54 | $1,148.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $4,365.16 | Facility | None | $602.56 | $1,513.56 | $4,365.16 |
AllWays Health Partners Setting Professional Modifier None Typical Low $512.86 Median $1,023.29 Typical High $4,897.79 | Professional | None | $512.86 | $1,023.29 | $4,897.79 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $436.52 Median $524.81 Typical High $1,000.00 | Facility | None | $436.52 | $524.81 | $1,000.00 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,348.96 | Professional | None | $851.14 | $851.14 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,445.44 Typical High $2,089.30 | Facility | None | $831.76 | $1,445.44 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $851.14 Typical High $1,548.82 | Professional | None | $389.05 | $851.14 | $1,548.82 |
Fallon Health Setting Facility Modifier None Typical Low $426.58 Median $562.34 Typical High $3,311.31 | Facility | None | $426.58 | $562.34 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,148.15 | Professional | None | $691.83 | $831.76 | $1,148.15 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $512.86 Median $1,000.00 Typical High $1,621.81 | Professional | None | $512.86 | $1,000.00 | $1,621.81 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $4,365.16 | Facility | None | $602.56 | $1,513.56 | $4,365.16 |
Mass General Brigham Setting Professional Modifier None Typical Low $512.86 Median $1,023.29 Typical High $4,897.79 | Professional | None | $512.86 | $1,023.29 | $4,897.79 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,762.47 | Facility | None | $1,047.13 | $2,344.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $1,659.59 | Professional | None | $512.86 | $741.31 | $1,659.59 |
Well Sense Setting Facility Modifier None Typical Low $398.11 Median $588.84 Typical High $831.76 | Facility | None | $398.11 | $588.84 | $831.76 |
Well Sense Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $457.09 | Professional | None | $309.03 | $380.19 | $457.09 |
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 $218.78 Median $275.42 Typical High $575.44 | Professional | 52 · Reduced service | $218.78 | $275.42 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $109.65 Typical High $229.09 | Professional | 53 · Discontinued | $87.10 | $109.65 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $407.38 Typical High $870.96 | Professional | 54 · Surgery only | $331.13 | $407.38 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $173.78 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $54.95 Typical High $114.82 | Professional | 56 · Pre-op care only | $43.65 | $54.95 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $380.19 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $309.03 | $380.19 | $812.83 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $239.88 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $199.53 | $239.88 | $288.40 |
Where Massachusetts sits
The same service costs 6.5 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· 10th of 51
$871
AK $2,239UT $347
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.