How much rates vary
Facilitymedian $437 · 10th to 90th $174 to $3,388Professionalmedian $437 · 10th to 90th $214 to $1,047
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 $691.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $691.83 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $524.81 | Professional | None | $141.25 | $218.78 | $524.81 |
AllWays Health Partners Setting Facility Modifier None Typical Low $194.98 Median $1,174.90 Typical High $3,715.35 | Facility | None | $194.98 | $1,174.90 | $3,715.35 |
AllWays Health Partners Setting Professional Modifier None Typical Low $208.93 Median $467.74 Typical High $2,187.76 | Professional | None | $208.93 | $467.74 | $2,187.76 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $457.09 | Facility | None | $199.53 | $199.53 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $251.19 Typical High $363.08 | Facility | None | $53.70 | $251.19 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $724.44 | Professional | None | $229.09 | $416.87 | $724.44 |
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 $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $223.87 Median $457.09 Typical High $831.76 | Professional | None | $223.87 | $457.09 | $831.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $194.98 Median $1,174.90 Typical High $3,715.35 | Facility | None | $194.98 | $1,174.90 | $3,715.35 |
Mass General Brigham Setting Professional Modifier None Typical Low $208.93 Median $467.74 Typical High $2,187.76 | Professional | None | $208.93 | $467.74 | $2,187.76 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,918.31 | Facility | None | $575.44 | $1,380.38 | $6,918.31 |
United Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $812.83 | Professional | None | $208.93 | $380.19 | $812.83 |
Well Sense Setting Facility Modifier None Typical Low $154.88 Median $223.87 Typical High $338.84 | Facility | None | $154.88 | $223.87 | $338.84 |
Well Sense Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $229.09 | Professional | None | $138.04 | $165.96 | $229.09 |
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 $69.18 Median $109.65 Typical High $257.04 | Professional | 52 · Reduced service | $69.18 | $109.65 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $43.65 Typical High $104.71 | Professional | 53 · Discontinued | $28.18 | $43.65 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $162.18 Typical High $389.05 | Professional | 54 · Surgery only | $104.71 | $162.18 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $32.36 Typical High $77.62 | Professional | 55 · Aftercare only | $20.89 | $32.36 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $21.88 Typical High $52.48 | Professional | 56 · Pre-op care only | $14.13 | $21.88 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $151.36 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $97.72 | $151.36 | $363.08 |
Where Massachusetts sits
The same service costs 3.5 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· 9th of 51
$437
AK $759TX $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.