How much rates vary
Facilitymedian $55 · 10th to 90th $25 to $224Professionalmedian $39 · 10th to 90th $26 to $91
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 $26.30 Median $40.74 Typical High $138.04 | Facility | None | $26.30 | $40.74 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $43.65 | Professional | None | $25.70 | $26.30 | $43.65 |
AllWays Health Partners Setting Facility Modifier None Typical Low $66.07 Median $95.50 Typical High $134.90 | Facility | None | $66.07 | $95.50 | $134.90 |
AllWays Health Partners Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $104.71 | Professional | None | $30.20 | $39.81 | $104.71 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $165.96 Median $190.55 Typical High $257.04 | Facility | None | $165.96 | $190.55 | $257.04 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $107.15 Typical High $144.54 | Facility | None | $30.20 | $107.15 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $109.65 | Professional | None | $33.11 | $35.48 | $109.65 |
Fallon Health Setting Facility Modifier None Typical Low $23.44 Median $43.65 Typical High $70.79 | Facility | None | $23.44 | $43.65 | $70.79 |
Fallon Health Setting Professional Modifier None Typical Low $22.91 Median $35.48 Typical High $57.54 | Professional | None | $22.91 | $35.48 | $57.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $91.20 | Professional | None | $36.31 | $42.66 | $91.20 |
Health New England Setting Facility Modifier None Typical Low $60.26 Median $107.15 Typical High $234.42 | Facility | None | $60.26 | $107.15 | $234.42 |
Health New England Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $162.18 | Professional | None | $50.12 | $75.86 | $162.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $66.07 Median $95.50 Typical High $134.90 | Facility | None | $66.07 | $95.50 | $134.90 |
Mass General Brigham Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $104.71 | Professional | None | $30.20 | $39.81 | $104.71 |
Tufts Setting Facility Modifier None Typical Low $24.55 Median $45.71 Typical High $436.52 | Facility | None | $24.55 | $45.71 | $436.52 |
Tufts Setting Professional Modifier None Typical Low $15.14 Median $24.55 Typical High $35.48 | Professional | None | $15.14 | $24.55 | $35.48 |
United Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $38.90 | Facility | None | $34.67 | $34.67 | $38.90 |
United Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $61.66 | Professional | None | $31.62 | $42.66 | $61.66 |
Well Sense Setting Facility Modifier None Typical Low $28.84 Median $39.81 Typical High $58.88 | Facility | None | $28.84 | $39.81 | $58.88 |
Well Sense Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $28.84 | Professional | None | $23.99 | $23.99 | $28.84 |
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 |
|---|---|---|---|---|---|
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.77 | $9.77 | $9.77 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 54 · Surgery only | $27.54 | $27.54 | $27.54 |
BCBS Massachusetts Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $7.76 |
BCBS Massachusetts Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $3.89 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 80 · Assistant surgeon | $6.31 | $6.31 | $6.31 |
Where Massachusetts sits
The same service costs 3.2 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· 17th of 51
$38.90
AK $70.79VA $22.39
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.