How much rates vary
Facilitymedian $309 · 10th to 90th $107 to $2,512Professionalmedian $240 · 10th to 90th $117 to $550
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 $371.54 Median $2,137.96 Typical High $3,630.78 | Facility | None | $371.54 | $2,137.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $288.40 | Professional | None | $87.10 | $128.82 | $288.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $275.42 Median $707.95 Typical High $1,995.26 | Facility | None | $275.42 | $707.95 | $1,995.26 |
AllWays Health Partners Setting Professional Modifier None Typical Low $128.82 Median $281.84 Typical High $1,288.25 | Professional | None | $128.82 | $281.84 | $1,288.25 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $269.15 | Facility | None | $117.49 | $141.25 | $269.15 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $354.81 | Professional | None | $117.49 | $204.17 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $223.87 Typical High $489.78 | Facility | None | $100.00 | $223.87 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $436.52 | Professional | None | $131.83 | $204.17 | $436.52 |
Fallon Health Setting Facility Modifier None Typical Low $107.15 Median $147.91 Typical High $3,311.31 | Facility | None | $107.15 | $147.91 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $302.00 | Professional | None | $218.78 | $257.04 | $302.00 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $128.82 Median $269.15 Typical High $489.78 | Professional | None | $128.82 | $269.15 | $489.78 |
Health New England Setting Facility Modifier None Typical Low $162.18 Median $575.44 Typical High $2,511.89 | Facility | None | $162.18 | $575.44 | $2,511.89 |
Health New England Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $588.84 | Professional | None | $117.49 | $141.25 | $588.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $275.42 Median $707.95 Typical High $1,995.26 | Facility | None | $275.42 | $707.95 | $1,995.26 |
Mass General Brigham Setting Professional Modifier None Typical Low $128.82 Median $281.84 Typical High $1,288.25 | Professional | None | $128.82 | $281.84 | $1,288.25 |
Tufts Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $165.96 | Professional | None | $66.07 | $93.33 | $165.96 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $489.78 | Professional | None | $125.89 | $223.87 | $489.78 |
Well Sense Setting Facility Modifier None Typical Low $95.50 Median $134.90 Typical High $204.17 | Facility | None | $95.50 | $134.90 | $204.17 |
Well Sense Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $138.04 | Professional | None | $79.43 | $95.50 | $138.04 |
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 $43.65 Median $64.57 Typical High $141.25 | Professional | 52 · Reduced service | $43.65 | $64.57 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $25.70 Typical High $57.54 | Professional | 53 · Discontinued | $17.38 | $25.70 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $95.50 Typical High $213.80 | Professional | 54 · Surgery only | $64.57 | $95.50 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $19.05 Typical High $42.66 | Professional | 55 · Aftercare only | $12.88 | $19.05 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $8.71 | $12.88 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $89.13 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $60.26 | $89.13 | $199.53 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $162.18 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $93.33 | $162.18 | $213.80 |
Where Massachusetts sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 8th of 51
$240
AK $525KY $138
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.