How much rates vary
Facilitymedian $398 · 10th to 90th $182 to $2,884Professionalmedian $417 · 10th to 90th $204 to $933
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 $158.49 Median $229.09 Typical High $537.03 | Professional | None | $158.49 | $229.09 | $537.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $794.33 Typical High $2,884.03 | Facility | None | $323.59 | $794.33 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $229.09 Median $489.78 Typical High $2,187.76 | Professional | None | $229.09 | $489.78 | $2,187.76 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $199.53 Median $239.88 Typical High $457.09 | Facility | None | $199.53 | $239.88 | $457.09 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $602.56 | Professional | None | $199.53 | $346.74 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $281.84 Typical High $416.87 | Facility | None | $53.70 | $281.84 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $741.31 | Professional | None | $234.42 | $346.74 | $741.31 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $245.47 Typical High $3,311.31 | Facility | None | $177.83 | $245.47 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $524.81 | Professional | None | $371.54 | $436.52 | $524.81 |
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 $229.09 Median $467.74 Typical High $831.76 | Professional | None | $229.09 | $467.74 | $831.76 |
Health New England Setting Facility Modifier None Typical Low $158.49 Median $426.58 Typical High $912.01 | Facility | None | $158.49 | $426.58 | $912.01 |
Health New England Setting Professional Modifier None Typical Low $239.88 Median $245.47 Typical High $457.09 | Professional | None | $239.88 | $245.47 | $457.09 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $794.33 Typical High $2,884.03 | Facility | None | $323.59 | $794.33 | $2,884.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $229.09 Median $489.78 Typical High $2,187.76 | Professional | None | $229.09 | $489.78 | $2,187.76 |
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 $218.78 Median $398.11 Typical High $831.76 | Professional | None | $218.78 | $398.11 | $831.76 |
Well Sense Setting Facility Modifier None Typical Low $154.88 Median $234.42 Typical High $363.08 | Facility | None | $154.88 | $234.42 | $363.08 |
Well Sense Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $257.04 | Professional | None | $151.36 | $181.97 | $257.04 |
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 $79.43 Median $114.82 Typical High $263.03 | Professional | 52 · Reduced service | $79.43 | $114.82 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $45.71 Typical High $107.15 | Professional | 53 · Discontinued | $31.62 | $45.71 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $173.78 Typical High $398.11 | Professional | 54 · Surgery only | $120.23 | $173.78 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $34.67 Typical High $79.43 | Professional | 55 · Aftercare only | $23.99 | $34.67 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $22.91 Typical High $53.70 | Professional | 56 · Pre-op care only | $15.85 | $22.91 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $162.18 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $112.20 | $162.18 | $371.54 |
Where Massachusetts sits
The same service costs 3.9 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
$417
AK $851TX $219
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.