How much rates vary
Facilitymedian $200 · 10th to 90th $87 to $2,239Professionalmedian $229 · 10th to 90th $123 to $525
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 $173.78 Median $2,137.96 Typical High $3,388.44 | Facility | None | $173.78 | $2,137.96 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $416.87 | Professional | None | $131.83 | $173.78 | $416.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $85.11 Median $389.05 Typical High $1,819.70 | Facility | None | $85.11 | $389.05 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $1,174.90 | Professional | None | $123.03 | $257.04 | $1,174.90 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $107.15 Median $128.82 Typical High $245.47 | Facility | None | $107.15 | $128.82 | $245.47 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $323.59 | Professional | None | $107.15 | $186.21 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $199.53 Typical High $489.78 | Facility | None | $154.88 | $199.53 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $426.58 | Professional | None | $125.89 | $223.87 | $426.58 |
Fallon Health Setting Facility Modifier None Typical Low $97.72 Median $138.04 Typical High $3,311.31 | Facility | None | $97.72 | $138.04 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $281.84 | Professional | None | $199.53 | $234.42 | $281.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $131.83 Median $245.47 Typical High $446.68 | Professional | None | $131.83 | $245.47 | $446.68 |
Health New England Setting Facility Modifier None Typical Low $158.49 Median $588.84 Typical High $4,570.88 | Facility | None | $158.49 | $588.84 | $4,570.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $85.11 Median $389.05 Typical High $1,819.70 | Facility | None | $85.11 | $389.05 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $1,174.90 | Professional | None | $123.03 | $257.04 | $1,174.90 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $457.09 | Professional | None | $131.83 | $218.78 | $457.09 |
Well Sense Setting Facility Modifier None Typical Low $85.11 Median $123.03 Typical High $186.21 | Facility | None | $85.11 | $123.03 | $186.21 |
Well Sense Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $186.21 | Professional | None | $125.89 | $151.36 | $186.21 |
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 $66.07 Median $85.11 Typical High $229.09 | Professional | 52 · Reduced service | $66.07 | $85.11 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $34.67 Typical High $91.20 | Professional | 53 · Discontinued | $26.30 | $34.67 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $128.82 Typical High $346.74 | Professional | 54 · Surgery only | $100.00 | $128.82 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $25.70 Typical High $69.18 | Professional | 55 · Aftercare only | $19.95 | $25.70 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $17.38 Typical High $45.71 | Professional | 56 · Pre-op care only | $13.18 | $17.38 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $120.23 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $93.33 | $120.23 | $323.59 |
Where Massachusetts sits
The same service costs 3.2 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· 11th of 51
$229
AK $427TX $132
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.