How much rates vary
Facilitymedian $126 · 10th to 90th $66 to $2,239Professionalmedian $135 · 10th to 90th $68 to $309
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 $251.19 Median $2,187.76 Typical High $3,630.78 | Facility | None | $251.19 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $173.78 | Professional | None | $52.48 | $72.44 | $173.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $52.48 Median $295.12 Typical High $1,862.09 | Facility | None | $52.48 | $295.12 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $75.86 Median $162.18 Typical High $724.44 | Professional | None | $75.86 | $162.18 | $724.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $154.88 | Facility | None | $67.61 | $67.61 | $154.88 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $67.61 Median $114.82 Typical High $199.53 | Professional | None | $67.61 | $114.82 | $199.53 |
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 $79.43 Median $117.49 Typical High $251.19 | Professional | None | $79.43 | $117.49 | $251.19 |
Fallon Health Setting Facility Modifier None Typical Low $66.07 Median $87.10 Typical High $3,311.31 | Facility | None | $66.07 | $87.10 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $169.82 | Professional | None | $123.03 | $144.54 | $169.82 |
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 $75.86 Median $154.88 Typical High $275.42 | Professional | None | $75.86 | $154.88 | $275.42 |
Health New England Setting Professional Modifier None Typical Low $67.61 Median $120.23 Typical High $147.91 | Professional | None | $67.61 | $120.23 | $147.91 |
Mass General Brigham Setting Facility Modifier None Typical Low $52.48 Median $295.12 Typical High $1,862.09 | Facility | None | $52.48 | $295.12 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $75.86 Median $162.18 Typical High $724.44 | Professional | None | $75.86 | $162.18 | $724.44 |
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 $72.44 Median $128.82 Typical High $281.84 | Professional | None | $72.44 | $128.82 | $281.84 |
Well Sense Setting Facility Modifier None Typical Low $53.70 Median $85.11 Typical High $123.03 | Facility | None | $53.70 | $85.11 | $123.03 |
Well Sense Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $83.18 | Professional | None | $48.98 | $58.88 | $83.18 |
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 $26.30 Median $36.31 Typical High $87.10 | Professional | 52 · Reduced service | $26.30 | $36.31 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $14.45 Typical High $34.67 | Professional | 53 · Discontinued | $10.47 | $14.45 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $54.95 Typical High $131.83 | Professional | 54 · Surgery only | $39.81 | $54.95 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.96 Typical High $26.30 | Professional | 55 · Aftercare only | $7.94 | $10.96 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.24 Typical High $17.38 | Professional | 56 · Pre-op care only | $5.25 | $7.24 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $37.15 Median $51.29 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $37.15 | $51.29 | $123.03 |
Where Massachusetts sits
The same service costs 3.8 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· 9th of 51
$135
AK $288KY $75.86
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.