How much rates vary
Facilitymedian $537 · 10th to 90th $331 to $2,884Professionalmedian $776 · 10th to 90th $389 to $1,950
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 $501.19 Median $2,691.53 Typical High $5,128.61 | Facility | None | $501.19 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $1,096.48 | Professional | None | $346.74 | $501.19 | $1,096.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $2,884.03 | Facility | None | $354.81 | $912.01 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $380.19 Median $870.96 Typical High $3,548.13 | Professional | None | $380.19 | $870.96 | $3,548.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $851.14 | Facility | None | $371.54 | $371.54 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $489.78 Typical High $630.96 | Facility | None | $446.68 | $489.78 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $1,202.26 | Professional | None | $426.58 | $575.44 | $1,202.26 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $446.68 Typical High $3,311.31 | Facility | None | $177.83 | $446.68 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $851.14 | Professional | None | $602.56 | $707.95 | $851.14 |
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 $436.52 Median $831.76 Typical High $1,380.38 | Professional | None | $436.52 | $831.76 | $1,380.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $2,884.03 | Facility | None | $354.81 | $912.01 | $2,884.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $380.19 Median $870.96 Typical High $3,548.13 | Professional | None | $380.19 | $870.96 | $3,548.13 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $7,244.36 | Facility | None | $407.38 | $870.96 | $7,244.36 |
United Setting Professional Modifier None Typical Low $426.58 Median $724.44 Typical High $1,445.44 | Professional | None | $426.58 | $724.44 | $1,445.44 |
Well Sense Setting Facility Modifier None Typical Low $309.03 Median $416.87 Typical High $660.69 | Facility | None | $309.03 | $416.87 | $660.69 |
Well Sense Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $501.19 | Professional | None | $302.00 | $363.08 | $501.19 |
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 $173.78 Median $251.19 Typical High $549.54 | Professional | 52 · Reduced service | $173.78 | $251.19 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $100.00 Typical High $218.78 | Professional | 53 · Discontinued | $69.18 | $100.00 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $380.19 Typical High $812.83 | Professional | 54 · Surgery only | $263.03 | $380.19 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $75.86 Typical High $162.18 | Professional | 55 · Aftercare only | $52.48 | $75.86 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $50.12 Typical High $109.65 | Professional | 56 · Pre-op care only | $34.67 | $50.12 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $354.81 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $245.47 | $354.81 | $758.58 |
Where Massachusetts sits
The same service costs 5.1 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
$759
AK $1,514TX $295
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.