How much rates vary
Facilitymedian $288 · 10th to 90th $123 to $692Professionalmedian $309 · 10th to 90th $178 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 $138.04 Median $316.23 Typical High $380.19 | Facility | None | $138.04 | $316.23 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | None | $223.87 | $223.87 | $251.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $501.19 Median $645.65 Typical High $724.44 | Facility | None | $501.19 | $645.65 | $724.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $204.17 Median $537.03 Typical High $1,122.02 | Professional | None | $204.17 | $537.03 | $1,122.02 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $446.68 Median $524.81 Typical High $691.83 | Facility | None | $446.68 | $524.81 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $724.44 Typical High $1,174.90 | Facility | None | $316.23 | $724.44 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $478.63 | Professional | None | $229.09 | $302.00 | $478.63 |
Fallon Health Setting Facility Modifier None Typical Low $109.65 Median $204.17 Typical High $309.03 | Facility | None | $109.65 | $204.17 | $309.03 |
Fallon Health Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $316.23 | Professional | None | $117.49 | $199.53 | $316.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $208.93 Median $416.87 Typical High $588.84 | Professional | None | $208.93 | $416.87 | $588.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $501.19 Median $645.65 Typical High $724.44 | Facility | None | $501.19 | $645.65 | $724.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $204.17 Median $537.03 Typical High $1,122.02 | Professional | None | $204.17 | $537.03 | $1,122.02 |
United Setting Facility Modifier None Typical Low $457.09 Median $870.96 Typical High $1,288.25 | Facility | None | $457.09 | $870.96 | $1,288.25 |
United Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $616.60 | Professional | None | $186.21 | $263.03 | $616.60 |
Well Sense Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $275.42 | Facility | None | $134.90 | $186.21 | $275.42 |
Well Sense Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $190.55 | Professional | None | $141.25 | $141.25 | $190.55 |
5 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 $112.20 Median $112.20 Typical High $125.89 | Professional | 52 · Reduced service | $112.20 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $50.12 | Professional | 53 · Discontinued | $44.67 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $37.15 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $25.12 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $25.12 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $107.15 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $89.13 | $107.15 | $120.23 |
Where Massachusetts sits
The same service costs 2.9 times more in Alaska than in Florida. 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
$309
AK $447FL $155
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.