How much rates vary
Facilitymedian $1,862 · 10th to 90th $692 to $5,888Professionalmedian $1,905 · 10th to 90th $977 to $6,918
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 $2,089.30 Median $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $2,511.89 | Professional | None | $977.24 | $977.24 | $2,511.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $2,290.87 Typical High $6,456.54 | Facility | None | $549.54 | $2,290.87 | $6,456.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,047.13 Median $2,630.27 Typical High $6,918.31 | Professional | None | $1,047.13 | $2,630.27 | $6,918.31 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $2,187.76 | Professional | None | $691.83 | $691.83 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,290.87 Typical High $3,311.31 | Facility | None | $676.08 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,621.81 Typical High $3,715.35 | Professional | None | $851.14 | $1,621.81 | $3,715.35 |
Fallon Health Setting Facility Modifier None Typical Low $933.25 Median $1,318.26 Typical High $3,311.31 | Facility | None | $933.25 | $1,318.26 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,380.38 | $1,862.09 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,096.48 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,096.48 | $2,187.76 | $3,090.30 |
Health New England Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Health New England Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $2,290.87 Typical High $6,456.54 | Facility | None | $549.54 | $2,290.87 | $6,456.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,047.13 Median $2,630.27 Typical High $6,918.31 | Professional | None | $1,047.13 | $2,630.27 | $6,918.31 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $10,471.29 | Facility | None | $851.14 | $2,818.38 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $3,801.89 | Professional | None | $1,000.00 | $1,380.38 | $3,801.89 |
Well Sense Setting Facility Modifier None Typical Low $691.83 Median $1,148.15 Typical High $1,659.59 | Facility | None | $691.83 | $1,148.15 | $1,659.59 |
Well Sense Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $812.83 | Professional | None | $676.08 | $676.08 | $812.83 |
6 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 $489.78 Median $489.78 Typical High $1,258.93 | Professional | 52 · Reduced service | $489.78 | $489.78 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $501.19 | Professional | 53 · Discontinued | $194.98 | $194.98 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $1,905.46 | Professional | 54 · Surgery only | $724.44 | $724.44 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $380.19 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $251.19 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $1,778.28 |
Where Massachusetts sits
The same service costs 7.2 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· 12th of 51
$1,862
AK $4,266UT $589
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.