How much rates vary
Facilitymedian $200 · 10th to 90th $83 to $2,344Professionalmedian $229 · 10th to 90th $98 to $603
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 $354.81 Median $2,187.76 Typical High $3,630.78 | Facility | None | $354.81 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $229.09 | Professional | None | $72.44 | $131.83 | $229.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $75.86 Median $389.05 Typical High $1,862.09 | Facility | None | $75.86 | $389.05 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $100.00 Median $245.47 Typical High $1,230.27 | Professional | None | $100.00 | $245.47 | $1,230.27 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $102.33 Median $125.89 Typical High $234.42 | Facility | None | $102.33 | $125.89 | $234.42 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $338.84 | Professional | None | $123.03 | $177.83 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $100.00 | Facility | None | $50.12 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $426.58 | Professional | None | $114.82 | $208.93 | $426.58 |
Fallon Health Setting Facility Modifier None Typical Low $93.33 Median $131.83 Typical High $3,311.31 | Facility | None | $93.33 | $131.83 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $295.12 | Professional | None | $208.93 | $245.47 | $295.12 |
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 $107.15 Median $239.88 Typical High $467.74 | Professional | None | $107.15 | $239.88 | $467.74 |
Health New England Setting Facility Modifier None Typical Low $151.36 Median $269.15 Typical High $281.84 | Facility | None | $151.36 | $269.15 | $281.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $75.86 Median $389.05 Typical High $1,862.09 | Facility | None | $75.86 | $389.05 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $100.00 Median $245.47 Typical High $1,230.27 | Professional | None | $100.00 | $245.47 | $1,230.27 |
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 $87.10 Median $204.17 Typical High $478.63 | Professional | None | $87.10 | $204.17 | $478.63 |
Well Sense Setting Facility Modifier None Typical Low $69.18 Median $128.82 Typical High $208.93 | Facility | None | $69.18 | $128.82 | $208.93 |
Well Sense Setting Professional Modifier None Typical Low $50.12 Median $58.88 Typical High $117.49 | Professional | None | $50.12 | $58.88 | $117.49 |
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 $36.31 Median $66.07 Typical High $91.20 | Professional | 52 · Reduced service | $36.31 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $26.30 Typical High $36.31 | Professional | 53 · Discontinued | $14.45 | $26.30 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $100.00 Typical High $134.90 | Professional | 54 · Surgery only | $53.70 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $19.95 Typical High $27.54 | Professional | 55 · Aftercare only | $10.96 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $13.18 Typical High $18.20 | Professional | 56 · Pre-op care only | $7.24 | $13.18 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $93.33 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $50.12 | $93.33 | $125.89 |
Where Massachusetts sits
The same service costs 4.5 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
$229
AK $407KY $91.20
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.