How much rates vary
Facilitymedian $288 · 10th to 90th $102 to $2,692Professionalmedian $224 · 10th to 90th $115 to $513
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 $169.82 Median $2,691.53 Typical High $3,715.35 | Facility | None | $169.82 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $281.84 | Professional | None | $83.18 | $120.23 | $281.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $263.03 Median $707.95 Typical High $1,995.26 | Facility | None | $263.03 | $707.95 | $1,995.26 |
AllWays Health Partners Setting Professional Modifier None Typical Low $123.03 Median $269.15 Typical High $1,202.26 | Professional | None | $123.03 | $269.15 | $1,202.26 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $257.04 | Facility | None | $112.20 | $138.04 | $257.04 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $331.13 | Professional | None | $112.20 | $194.98 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $199.53 Typical High $489.78 | Facility | None | $100.00 | $199.53 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $407.38 | Professional | None | $123.03 | $186.21 | $407.38 |
Fallon Health Setting Facility Modifier None Typical Low $102.33 Median $144.54 Typical High $3,311.31 | Facility | None | $102.33 | $144.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $281.84 | Professional | None | $204.17 | $239.88 | $281.84 |
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 $125.89 Median $257.04 Typical High $457.09 | Professional | None | $125.89 | $257.04 | $457.09 |
Health New England Setting Facility Modifier None Typical Low $123.03 Median $741.31 Typical High $1,862.09 | Facility | None | $123.03 | $741.31 | $1,862.09 |
Health New England Setting Professional Modifier None Typical Low $117.49 Median $257.04 Typical High $295.12 | Professional | None | $117.49 | $257.04 | $295.12 |
Mass General Brigham Setting Facility Modifier None Typical Low $263.03 Median $707.95 Typical High $1,995.26 | Facility | None | $263.03 | $707.95 | $1,995.26 |
Mass General Brigham Setting Professional Modifier None Typical Low $123.03 Median $269.15 Typical High $1,202.26 | Professional | None | $123.03 | $269.15 | $1,202.26 |
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 $120.23 Median $213.80 Typical High $457.09 | Professional | None | $120.23 | $213.80 | $457.09 |
Well Sense Setting Facility Modifier None Typical Low $89.13 Median $125.89 Typical High $194.98 | Facility | None | $89.13 | $125.89 | $194.98 |
Well Sense Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $131.83 | Professional | None | $77.62 | $93.33 | $131.83 |
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 $41.69 Median $60.26 Typical High $141.25 | Professional | 52 · Reduced service | $41.69 | $60.26 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $23.99 Typical High $56.23 | Professional | 53 · Discontinued | $16.60 | $23.99 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $91.20 Typical High $213.80 | Professional | 54 · Surgery only | $63.10 | $91.20 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $18.20 Typical High $42.66 | Professional | 55 · Aftercare only | $12.59 | $18.20 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.02 Typical High $28.18 | Professional | 56 · Pre-op care only | $8.32 | $12.02 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $85.11 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $58.88 | $85.11 | $199.53 |
Where Massachusetts sits
The same service costs 3.5 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· 8th of 51
$229
AK $447FL $126
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.