How much rates vary
Facilitymedian $302 · 10th to 90th $138 to $2,239Professionalmedian $427 · 10th to 90th $195 to $977
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 $257.04 Median $1,905.46 Typical High $3,388.44 | Facility | None | $257.04 | $1,905.46 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $549.54 | Professional | None | $154.88 | $223.87 | $549.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $138.04 Median $478.63 Typical High $1,862.09 | Facility | None | $138.04 | $478.63 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $223.87 Median $478.63 Typical High $2,344.23 | Professional | None | $223.87 | $478.63 | $2,344.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $194.98 Median $234.42 Typical High $446.68 | Facility | None | $194.98 | $234.42 | $446.68 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $645.65 | Professional | None | $194.98 | $371.54 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $281.84 Typical High $407.38 | Facility | None | $53.70 | $281.84 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $794.33 | Professional | None | $245.47 | $436.52 | $794.33 |
Fallon Health Setting Facility Modifier None Typical Low $194.98 Median $257.04 Typical High $3,311.31 | Facility | None | $194.98 | $257.04 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $549.54 | Professional | None | $398.11 | $467.74 | $549.54 |
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 $223.87 Median $457.09 Typical High $891.25 | Professional | None | $223.87 | $457.09 | $891.25 |
Health New England Setting Facility Modifier None Typical Low $245.47 Median $346.74 Typical High $3,715.35 | Facility | None | $245.47 | $346.74 | $3,715.35 |
Health New England Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $562.34 | Professional | None | $501.19 | $524.81 | $562.34 |
Mass General Brigham Setting Facility Modifier None Typical Low $138.04 Median $478.63 Typical High $1,862.09 | Facility | None | $138.04 | $478.63 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $223.87 Median $478.63 Typical High $2,344.23 | Professional | None | $223.87 | $478.63 | $2,344.23 |
Tufts Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $295.12 | Professional | None | $123.03 | $173.78 | $295.12 |
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 $213.80 Median $389.05 Typical High $891.25 | Professional | None | $213.80 | $389.05 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $138.04 Median $245.47 Typical High $371.54 | Facility | None | $138.04 | $245.47 | $371.54 |
Well Sense Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $263.03 | Professional | None | $154.88 | $186.21 | $263.03 |
7 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 $77.62 Median $112.20 Typical High $275.42 | Professional | 52 · Reduced service | $77.62 | $112.20 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $44.67 Typical High $109.65 | Professional | 53 · Discontinued | $30.90 | $44.67 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $169.82 Typical High $416.87 | Professional | 54 · Surgery only | $114.82 | $169.82 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $33.88 Typical High $83.18 | Professional | 55 · Aftercare only | $22.91 | $33.88 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.39 Typical High $54.95 | Professional | 56 · Pre-op care only | $15.49 | $22.39 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $158.49 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $107.15 | $158.49 | $389.05 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $295.12 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $154.88 | $295.12 | $549.54 |
Where Massachusetts sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 7th of 51
$427
AK $813MD $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.