How much rates vary
Facilitymedian $115 · 10th to 90th $41 to $2,239Professionalmedian $102 · 10th to 90th $41 to $295
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 $63.10 Median $1,819.70 Typical High $3,388.44 | Facility | None | $63.10 | $1,819.70 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $63.10 Typical High $141.25 | Professional | None | $28.18 | $63.10 | $141.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $295.12 Typical High $1,862.09 | Facility | None | $50.12 | $295.12 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $41.69 Median $109.65 Typical High $676.08 | Professional | None | $41.69 | $109.65 | $676.08 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $95.50 | Facility | None | $40.74 | $40.74 | $95.50 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $40.74 Median $109.65 Typical High $190.55 | Professional | None | $40.74 | $109.65 | $190.55 |
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 $41.69 Median $97.72 Typical High $194.98 | Professional | None | $41.69 | $97.72 | $194.98 |
Fallon Health Setting Facility Modifier None Typical Low $43.65 Median $52.48 Typical High $3,311.31 | Facility | None | $43.65 | $52.48 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $162.18 | Professional | None | $114.82 | $134.90 | $162.18 |
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 $44.67 Median $109.65 Typical High $257.04 | Professional | None | $44.67 | $109.65 | $257.04 |
Health New England Setting Facility Modifier None Typical Low $138.04 Median $218.78 Typical High $446.68 | Facility | None | $138.04 | $218.78 | $446.68 |
Health New England Setting Professional Modifier None Typical Low $134.90 Median $912.01 Typical High $912.01 | Professional | None | $134.90 | $912.01 | $912.01 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $295.12 Typical High $1,862.09 | Facility | None | $50.12 | $295.12 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $41.69 Median $109.65 Typical High $676.08 | Professional | None | $41.69 | $109.65 | $676.08 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $41.69 Median $100.00 Typical High $251.19 | Professional | None | $41.69 | $100.00 | $251.19 |
Well Sense Setting Facility Modifier None Typical Low $33.11 Median $58.88 Typical High $107.15 | Facility | None | $33.11 | $58.88 | $107.15 |
Well Sense Setting Professional Modifier None Typical Low $25.70 Median $30.90 Typical High $66.07 | Professional | None | $25.70 | $30.90 | $66.07 |
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 $13.80 Median $31.62 Typical High $47.86 | Professional | 52 · Reduced service | $13.80 | $31.62 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $12.59 Typical High $19.05 | Professional | 53 · Discontinued | $5.62 | $12.59 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $46.77 Typical High $70.79 | Professional | 54 · Surgery only | $20.89 | $46.77 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $9.33 Typical High $14.13 | Professional | 55 · Aftercare only | $4.17 | $9.33 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $6.31 Typical High $9.55 | Professional | 56 · Pre-op care only | $2.82 | $6.31 | $9.55 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | 78 · Unplanned return to OR | $40.74 | $40.74 | $44.67 |
Where Massachusetts sits
The same service costs 3.7 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· 10th of 51
$102
AK $178KY $47.86
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.