How much rates vary
Facilitymedian $372 · 10th to 90th $158 to $2,512Professionalmedian $355 · 10th to 90th $166 to $794
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 $128.82 Median $194.98 Typical High $446.68 | Professional | None | $128.82 | $194.98 | $446.68 |
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 $186.21 Median $398.11 Typical High $1,862.09 | Professional | None | $186.21 | $398.11 | $1,862.09 |
BCBS Setting Facility Modifier None Typical Low $162.18 Median $199.53 Typical High $371.54 | Facility | None | $162.18 | $199.53 | $371.54 |
BCBS Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $512.86 | Professional | None | $162.18 | $295.12 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $309.03 Typical High $489.78 | Facility | None | $199.53 | $309.03 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $630.96 | Professional | None | $190.55 | $295.12 | $630.96 |
Fallon Health Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $3,311.31 | Facility | None | $147.91 | $204.17 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $446.68 | Professional | None | $316.23 | $371.54 | $446.68 |
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 $186.21 Median $380.19 Typical High $724.44 | Professional | None | $186.21 | $380.19 | $724.44 |
Health New England Setting Facility Modifier None Typical Low $281.84 Median $933.25 Typical High $2,041.74 | Facility | None | $281.84 | $933.25 | $2,041.74 |
Health New England Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $234.42 | Professional | None | $181.97 | $199.53 | $234.42 |
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 $186.21 Median $398.11 Typical High $1,862.09 | Professional | None | $186.21 | $398.11 | $1,862.09 |
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 $181.97 Median $331.13 Typical High $724.44 | Professional | None | $181.97 | $331.13 | $724.44 |
Well Sense Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $295.12 | Facility | None | $141.25 | $194.98 | $295.12 |
Well Sense Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $218.78 | Professional | None | $123.03 | $147.91 | $218.78 |
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 $64.57 Median $97.72 Typical High $218.78 | Professional | 52 · Reduced service | $64.57 | $97.72 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $39.81 Typical High $87.10 | Professional | 53 · Discontinued | $25.70 | $39.81 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $147.91 Typical High $323.59 | Professional | 54 · Surgery only | $97.72 | $147.91 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $29.51 Typical High $64.57 | Professional | 55 · Aftercare only | $19.50 | $29.51 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.50 Typical High $43.65 | Professional | 56 · Pre-op care only | $12.88 | $19.50 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $138.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $91.20 | $138.04 | $302.00 |
Where Massachusetts sits
The same service costs 3.4 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
$355
AK $692KY $204
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.