How much rates vary
Facilitymedian $490 · 10th to 90th $229 to $2,884Professionalmedian $417 · 10th to 90th $219 to $955
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 $436.52 Median $2,137.96 Typical High $3,630.78 | Facility | None | $436.52 | $2,137.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $575.44 | Professional | None | $169.82 | $213.80 | $575.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $2,884.03 | Facility | None | $338.84 | $851.14 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $218.78 Median $537.03 Typical High $2,137.96 | Professional | None | $218.78 | $537.03 | $2,137.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $229.09 Median $275.42 Typical High $512.86 | Facility | None | $229.09 | $275.42 | $512.86 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $602.56 | Professional | None | $229.09 | $389.05 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,445.44 | Facility | None | $446.68 | $977.24 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $707.95 | Professional | None | $257.04 | $331.13 | $707.95 |
Fallon Health Setting Facility Modifier None Typical Low $223.87 Median $295.12 Typical High $3,311.31 | Facility | None | $223.87 | $295.12 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $501.19 | Professional | None | $363.08 | $426.58 | $501.19 |
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 $257.04 Median $524.81 Typical High $812.83 | Professional | None | $257.04 | $524.81 | $812.83 |
Health New England Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Health New England Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | None | $223.87 | $223.87 | $263.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $2,884.03 | Facility | None | $338.84 | $851.14 | $2,884.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $218.78 Median $537.03 Typical High $2,137.96 | Professional | None | $218.78 | $537.03 | $2,137.96 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $5,370.32 | Facility | None | $407.38 | $870.96 | $5,370.32 |
United Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $794.33 | Professional | None | $245.47 | $380.19 | $794.33 |
Well Sense Setting Facility Modifier None Typical Low $204.17 Median $295.12 Typical High $489.78 | Facility | None | $204.17 | $295.12 | $489.78 |
Well Sense Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $239.88 | Professional | None | $162.18 | $194.98 | $239.88 |
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 $85.11 Median $107.15 Typical High $288.40 | Professional | 52 · Reduced service | $85.11 | $107.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $42.66 Typical High $114.82 | Professional | 53 · Discontinued | $33.88 | $42.66 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $158.49 Typical High $436.52 | Professional | 54 · Surgery only | $128.82 | $158.49 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $87.10 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.38 Typical High $57.54 | Professional | 56 · Pre-op care only | $16.98 | $21.38 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $147.91 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $120.23 | $147.91 | $407.38 |
Where Massachusetts sits
The same service costs 3.9 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
$427
AK $912KY $234
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.