How much rates vary
Facilitymedian $794 · 10th to 90th $324 to $3,981Professionalmedian $676 · 10th to 90th $324 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 $1,000.00 Median $2,818.38 Typical High $4,677.35 | Facility | None | $1,000.00 | $2,818.38 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $707.95 | Professional | None | $316.23 | $478.63 | $707.95 |
AllWays Health Partners Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $4,365.16 | Facility | None | $512.86 | $1,479.11 | $4,365.16 |
AllWays Health Partners Setting Professional Modifier None Typical Low $354.81 Median $812.83 Typical High $3,715.35 | Professional | None | $354.81 | $812.83 | $3,715.35 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $323.59 Median $389.05 Typical High $741.31 | Facility | None | $323.59 | $389.05 | $741.31 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $977.24 | Professional | None | $323.59 | $575.44 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,445.44 Typical High $2,089.30 | Facility | None | $676.08 | $1,445.44 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $724.44 Typical High $1,202.26 | Professional | None | $281.84 | $724.44 | $1,202.26 |
Fallon Health Setting Facility Modifier None Typical Low $316.23 Median $416.87 Typical High $3,311.31 | Facility | None | $316.23 | $416.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,000.00 | Professional | None | $588.84 | $724.44 | $1,000.00 |
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 $338.84 Median $724.44 Typical High $1,348.96 | Professional | None | $338.84 | $724.44 | $1,348.96 |
Health New England Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Health New England Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $776.25 | Professional | None | $741.31 | $741.31 | $776.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $4,365.16 | Facility | None | $512.86 | $1,479.11 | $4,365.16 |
Mass General Brigham Setting Professional Modifier None Typical Low $354.81 Median $812.83 Typical High $3,715.35 | Professional | None | $354.81 | $812.83 | $3,715.35 |
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 $338.84 Median $575.44 Typical High $1,380.38 | Professional | None | $338.84 | $575.44 | $1,380.38 |
Well Sense Setting Facility Modifier None Typical Low $281.84 Median $489.78 Typical High $741.31 | Facility | None | $281.84 | $489.78 | $741.31 |
Well Sense Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $316.23 | Professional | None | $190.55 | $257.04 | $316.23 |
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 $158.49 Median $239.88 Typical High $354.81 | Professional | 52 · Reduced service | $158.49 | $239.88 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $95.50 Typical High $141.25 | Professional | 53 · Discontinued | $63.10 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $354.81 Typical High $524.81 | Professional | 54 · Surgery only | $234.42 | $354.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $70.79 Typical High $107.15 | Professional | 55 · Aftercare only | $46.77 | $70.79 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $47.86 Typical High $70.79 | Professional | 56 · Pre-op care only | $31.62 | $47.86 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $331.13 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $218.78 | $331.13 | $489.78 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $165.96 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $123.03 | $165.96 | $199.53 |
Where Massachusetts sits
The same service costs 5.9 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
$692
AK $1,698UT $288
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.