How much rates vary
Facilitymedian $302 · 10th to 90th $100 to $2,692Professionalmedian $204 · 10th to 90th $105 to $457
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 $263.03 Median $2,691.53 Typical High $3,715.35 | Facility | None | $263.03 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $257.04 | Professional | None | $79.43 | $104.71 | $257.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $269.15 Median $707.95 Typical High $1,995.26 | Facility | None | $269.15 | $707.95 | $1,995.26 |
AllWays Health Partners Setting Professional Modifier None Typical Low $112.20 Median $269.15 Typical High $1,071.52 | Professional | None | $112.20 | $269.15 | $1,071.52 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $114.82 Median $138.04 Typical High $263.03 | Facility | None | $114.82 | $138.04 | $263.03 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $302.00 | Professional | None | $114.82 | $194.98 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $194.98 Typical High $489.78 | Facility | None | $100.00 | $194.98 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $363.08 | Professional | None | $123.03 | $169.82 | $363.08 |
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 $181.97 Median $213.80 Typical High $257.04 | Professional | None | $181.97 | $213.80 | $257.04 |
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 $120.23 Median $257.04 Typical High $416.87 | Professional | None | $120.23 | $257.04 | $416.87 |
Health New England Setting Facility Modifier None Typical Low $158.49 Median $707.95 Typical High $2,754.23 | Facility | None | $158.49 | $707.95 | $2,754.23 |
Health New England Setting Professional Modifier None Typical Low $120.23 Median $234.42 Typical High $257.04 | Professional | None | $120.23 | $234.42 | $257.04 |
Mass General Brigham Setting Facility Modifier None Typical Low $269.15 Median $707.95 Typical High $1,995.26 | Facility | None | $269.15 | $707.95 | $1,995.26 |
Mass General Brigham Setting Professional Modifier None Typical Low $112.20 Median $269.15 Typical High $1,071.52 | Professional | None | $112.20 | $269.15 | $1,071.52 |
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 $112.20 Median $190.55 Typical High $416.87 | Professional | None | $112.20 | $190.55 | $416.87 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $190.55 | Facility | None | $87.10 | $120.23 | $190.55 |
Well Sense Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $112.20 | Professional | None | $72.44 | $87.10 | $112.20 |
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 $39.81 Median $52.48 Typical High $128.82 | Professional | 52 · Reduced service | $39.81 | $52.48 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.89 Typical High $51.29 | Professional | 53 · Discontinued | $15.85 | $20.89 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $79.43 Typical High $194.98 | Professional | 54 · Surgery only | $60.26 | $79.43 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.85 Typical High $38.90 | Professional | 55 · Aftercare only | $12.02 | $15.85 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.47 Typical High $25.70 | Professional | 56 · Pre-op care only | $7.94 | $10.47 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $74.13 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $56.23 | $74.13 | $181.97 |
Where Massachusetts sits
The same service costs 4.1 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
$209
AK $437KY $107
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.