How much rates vary
Facilitymedian $151 · 10th to 90th $78 to $2,239Professionalmedian $195 · 10th to 90th $85 to $457
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 $380.19 Median $2,187.76 Typical High $3,630.78 | Facility | None | $380.19 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $239.88 | Professional | None | $69.18 | $112.20 | $239.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $63.10 Median $295.12 Typical High $1,862.09 | Facility | None | $63.10 | $295.12 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $97.72 Median $213.80 Typical High $1,071.52 | Professional | None | $97.72 | $213.80 | $1,071.52 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $199.53 | Facility | None | $85.11 | $85.11 | $199.53 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $302.00 | Professional | None | $85.11 | $169.82 | $302.00 |
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 $100.00 Median $169.82 Typical High $338.84 | Professional | None | $100.00 | $169.82 | $338.84 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $107.15 Typical High $3,311.31 | Facility | None | $83.18 | $107.15 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $257.04 | Professional | None | $186.21 | $218.78 | $257.04 |
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 $100.00 Median $204.17 Typical High $407.38 | Professional | None | $100.00 | $204.17 | $407.38 |
Health New England Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $416.87 | Professional | None | $181.97 | $208.93 | $416.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $63.10 Median $295.12 Typical High $1,862.09 | Facility | None | $63.10 | $295.12 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $97.72 Median $213.80 Typical High $1,071.52 | Professional | None | $97.72 | $213.80 | $1,071.52 |
Tufts Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $141.25 | Professional | None | $57.54 | $83.18 | $141.25 |
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 $95.50 Median $186.21 Typical High $426.58 | Professional | None | $95.50 | $186.21 | $426.58 |
Well Sense Setting Facility Modifier None Typical Low $64.57 Median $114.82 Typical High $186.21 | Facility | None | $64.57 | $114.82 | $186.21 |
Well Sense Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $125.89 | Professional | None | $66.07 | $79.43 | $125.89 |
7 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 $34.67 Median $56.23 Typical High $120.23 | Professional | 52 · Reduced service | $34.67 | $56.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $22.39 Typical High $47.86 | Professional | 53 · Discontinued | $13.80 | $22.39 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $83.18 Typical High $177.83 | Professional | 54 · Surgery only | $52.48 | $83.18 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.60 Typical High $35.48 | Professional | 55 · Aftercare only | $10.47 | $16.60 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $11.22 Typical High $23.99 | Professional | 56 · Pre-op care only | $6.92 | $11.22 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $77.62 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $48.98 | $77.62 | $165.96 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $234.42 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $138.04 | $234.42 | $316.23 |
Where Massachusetts sits
The same service costs 3.5 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· 8th of 51
$191
AK $389KY $110
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.