How much rates vary
Facilitymedian $457 · 10th to 90th $138 to $2,344Professionalmedian $676 · 10th to 90th $372 to $3,311
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 $371.54 Median $2,691.53 Typical High $5,128.61 | Facility | None | $371.54 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $977.24 | Professional | None | $288.40 | $371.54 | $977.24 |
AllWays Health Partners 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 |
AllWays Health Partners Setting Professional Modifier None Typical Low $436.52 Median $1,000.00 Typical High $3,311.31 | Professional | None | $436.52 | $1,000.00 | $3,311.31 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $812.83 | Facility | None | $354.81 | $354.81 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $446.68 Typical High $501.19 | Facility | None | $338.84 | $446.68 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $1,122.02 | Professional | None | $407.38 | $537.03 | $1,122.02 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $426.58 Typical High $3,311.31 | Facility | None | $177.83 | $426.58 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $776.25 | Professional | None | $562.34 | $660.69 | $776.25 |
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 $407.38 Median $794.33 Typical High $1,258.93 | Professional | None | $407.38 | $794.33 | $1,258.93 |
Mass General Brigham 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 |
Mass General Brigham Setting Professional Modifier None Typical Low $436.52 Median $1,000.00 Typical High $3,311.31 | Professional | None | $436.52 | $1,000.00 | $3,311.31 |
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 $389.05 Median $630.96 Typical High $1,288.25 | Professional | None | $389.05 | $630.96 | $1,288.25 |
Well Sense Setting Facility Modifier None Typical Low $138.04 Median $380.19 Typical High $630.96 | Facility | None | $138.04 | $380.19 | $630.96 |
Well Sense Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $426.58 | Professional | None | $269.15 | $323.59 | $426.58 |
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 $144.54 Median $186.21 Typical High $489.78 | Professional | 52 · Reduced service | $144.54 | $186.21 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $74.13 Typical High $194.98 | Professional | 53 · Discontinued | $57.54 | $74.13 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $281.84 Typical High $724.44 | Professional | 54 · Surgery only | $213.80 | $281.84 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $56.23 Typical High $147.91 | Professional | 55 · Aftercare only | $42.66 | $56.23 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $37.15 Typical High $97.72 | Professional | 56 · Pre-op care only | $28.84 | $37.15 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $263.03 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $199.53 | $263.03 | $676.08 |
Where Massachusetts sits
The same service costs 6.0 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
$646
AK $1,445TX $240
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.