How much rates vary
Facilitymedian $407 · 10th to 90th $178 to $2,570Professionalmedian $389 · 10th to 90th $186 to $891
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $489.78 | Professional | None | $147.91 | $218.78 | $489.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $707.95 Typical High $1,995.26 | Facility | None | $323.59 | $707.95 | $1,995.26 |
AllWays Health Partners Setting Professional Modifier None Typical Low $204.17 Median $446.68 Typical High $2,041.74 | Professional | None | $204.17 | $446.68 | $2,041.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $186.21 Median $223.87 Typical High $416.87 | Facility | None | $186.21 | $223.87 | $416.87 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $562.34 | Professional | None | $186.21 | $323.59 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $323.59 Typical High $489.78 | Facility | None | $199.53 | $323.59 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $691.83 | Professional | None | $213.80 | $323.59 | $691.83 |
Fallon Health Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $3,311.31 | Facility | None | $165.96 | $223.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $489.78 | Professional | None | $354.81 | $416.87 | $489.78 |
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 $204.17 Median $426.58 Typical High $794.33 | Professional | None | $204.17 | $426.58 | $794.33 |
Health New England Setting Facility Modifier None Typical Low $144.54 Median $831.76 Typical High $5,011.87 | Facility | None | $144.54 | $831.76 | $5,011.87 |
Health New England Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $380.19 | Professional | None | $204.17 | $223.87 | $380.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $707.95 Typical High $1,995.26 | Facility | None | $323.59 | $707.95 | $1,995.26 |
Mass General Brigham Setting Professional Modifier None Typical Low $204.17 Median $446.68 Typical High $2,041.74 | Professional | None | $204.17 | $446.68 | $2,041.74 |
Tufts Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $263.03 | Professional | None | $112.20 | $158.49 | $263.03 |
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 $199.53 Median $371.54 Typical High $794.33 | Professional | None | $199.53 | $371.54 | $794.33 |
Well Sense Setting Facility Modifier None Typical Low $147.91 Median $218.78 Typical High $338.84 | Facility | None | $147.91 | $218.78 | $338.84 |
Well Sense Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $239.88 | Professional | None | $138.04 | $165.96 | $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 $74.13 Median $107.15 Typical High $239.88 | Professional | 52 · Reduced service | $74.13 | $107.15 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $43.65 Typical High $97.72 | Professional | 53 · Discontinued | $29.51 | $43.65 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $162.18 Typical High $363.08 | Professional | 54 · Surgery only | $109.65 | $162.18 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $32.36 Typical High $72.44 | Professional | 55 · Aftercare only | $21.88 | $32.36 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $21.88 Typical High $48.98 | Professional | 56 · Pre-op care only | $14.79 | $21.88 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $151.36 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $102.33 | $151.36 | $338.84 |
Where Massachusetts sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$389
AK $776TX $214
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.