How much rates vary
Facilitymedian $324 · 10th to 90th $132 to $2,692Professionalmedian $550 · 10th to 90th $251 to $4,169
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 $194.98 Median $371.54 Typical High $645.65 | Professional | None | $194.98 | $371.54 | $645.65 |
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 $295.12 Median $707.95 Typical High $4,168.69 | Professional | None | $295.12 | $707.95 | $4,168.69 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $537.03 | Facility | None | $229.09 | $229.09 | $537.03 |
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 $251.19 Median $446.68 Typical High $954.99 | Professional | None | $251.19 | $446.68 | $954.99 |
Fallon Health Setting Facility Modifier None Typical Low $223.87 Median $295.12 Typical High $3,311.31 | Facility | None | $223.87 | $295.12 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $691.83 | Professional | None | $489.78 | $575.44 | $691.83 |
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 $251.19 Median $549.54 Typical High $1,071.52 | Professional | None | $251.19 | $549.54 | $1,071.52 |
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 $295.12 Median $707.95 Typical High $4,168.69 | Professional | None | $295.12 | $707.95 | $4,168.69 |
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 $251.19 Median $524.81 Typical High $1,122.02 | Professional | None | $251.19 | $524.81 | $1,122.02 |
Well Sense Setting Facility Modifier None Typical Low $165.96 Median $309.03 Typical High $478.63 | Facility | None | $165.96 | $309.03 | $478.63 |
Well Sense Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $389.05 | Professional | None | $177.83 | $213.80 | $389.05 |
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 $95.50 Median $181.97 Typical High $316.23 | Professional | 52 · Reduced service | $95.50 | $181.97 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $74.13 Typical High $128.82 | Professional | 53 · Discontinued | $38.90 | $74.13 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $275.42 Typical High $478.63 | Professional | 54 · Surgery only | $144.54 | $275.42 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $54.95 Typical High $95.50 | Professional | 55 · Aftercare only | $28.84 | $54.95 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $37.15 Typical High $64.57 | Professional | 56 · Pre-op care only | $19.50 | $37.15 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $257.04 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $134.90 | $257.04 | $446.68 |
Where Massachusetts sits
The same service costs 4.6 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· 7th of 51
$525
AK $1,000TX $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.