How much rates vary
Facilitymedian $309 · 10th to 90th $115 to $2,884Professionalmedian $275 · 10th to 90th $126 to $661
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 $489.78 Median $2,187.76 Typical High $3,630.78 | Facility | None | $489.78 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $295.12 | Professional | None | $91.20 | $151.36 | $295.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $275.42 Median $794.33 Typical High $2,884.03 | Facility | None | $275.42 | $794.33 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $134.90 Median $302.00 Typical High $1,479.11 | Professional | None | $134.90 | $302.00 | $1,479.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $295.12 | Facility | None | $125.89 | $125.89 | $295.12 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $407.38 | Professional | None | $125.89 | $234.42 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $263.03 Typical High $489.78 | Facility | None | $100.00 | $263.03 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $467.74 | Professional | None | $138.04 | $229.09 | $467.74 |
Fallon Health Setting Facility Modifier None Typical Low $112.20 Median $154.88 Typical High $3,311.31 | Facility | None | $112.20 | $154.88 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $354.81 | Professional | None | $251.19 | $295.12 | $354.81 |
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 $134.90 Median $288.40 Typical High $562.34 | Professional | None | $134.90 | $288.40 | $562.34 |
Health New England Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $6,309.57 | Facility | None | $870.96 | $870.96 | $6,309.57 |
Health New England Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Mass General Brigham Setting Facility Modifier None Typical Low $275.42 Median $794.33 Typical High $2,884.03 | Facility | None | $275.42 | $794.33 | $2,884.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $134.90 Median $302.00 Typical High $1,479.11 | Professional | None | $134.90 | $302.00 | $1,479.11 |
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 $125.89 Median $257.04 Typical High $562.34 | Professional | None | $125.89 | $257.04 | $562.34 |
Well Sense Setting Facility Modifier None Typical Low $102.33 Median $154.88 Typical High $234.42 | Facility | None | $102.33 | $154.88 | $234.42 |
Well Sense Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $162.18 | Professional | None | $83.18 | $100.00 | $162.18 |
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 $45.71 Median $75.86 Typical High $147.91 | Professional | 52 · Reduced service | $45.71 | $75.86 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $30.20 Typical High $58.88 | Professional | 53 · Discontinued | $18.20 | $30.20 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $112.20 Typical High $218.78 | Professional | 54 · Surgery only | $69.18 | $112.20 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $22.39 Typical High $43.65 | Professional | 55 · Aftercare only | $13.80 | $22.39 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $15.14 Typical High $29.51 | Professional | 56 · Pre-op care only | $9.12 | $15.14 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $104.71 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $64.57 | $104.71 | $204.17 |
Where Massachusetts sits
The same service costs 3.6 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
$275
AK $501KY $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.