How much rates vary
Facilitymedian $200 · 10th to 90th $105 to $2,239Professionalmedian $263 · 10th to 90th $123 to $603
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 $512.86 Median $2,187.76 Typical High $3,630.78 | Facility | None | $512.86 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $331.13 | Professional | None | $97.72 | $147.91 | $331.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $85.11 Median $323.59 Typical High $1,862.09 | Facility | None | $85.11 | $323.59 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $134.90 Median $295.12 Typical High $1,412.54 | Professional | None | $134.90 | $295.12 | $1,412.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $269.15 | Facility | None | $114.82 | $114.82 | $269.15 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $114.82 Median $223.87 Typical High $389.05 | Professional | None | $114.82 | $223.87 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $199.53 Typical High $199.53 | Facility | None | $50.12 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $457.09 | Professional | None | $138.04 | $229.09 | $457.09 |
Fallon Health Setting Facility Modifier None Typical Low $107.15 Median $144.54 Typical High $3,311.31 | Facility | None | $107.15 | $144.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $331.13 | Professional | None | $239.88 | $281.84 | $331.13 |
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 $141.25 Median $275.42 Typical High $537.03 | Professional | None | $141.25 | $275.42 | $537.03 |
Health New England Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $323.59 | Professional | None | $239.88 | $269.15 | $323.59 |
Mass General Brigham Setting Facility Modifier None Typical Low $85.11 Median $323.59 Typical High $1,862.09 | Facility | None | $85.11 | $323.59 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $134.90 Median $295.12 Typical High $1,412.54 | Professional | None | $134.90 | $295.12 | $1,412.54 |
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 $134.90 Median $245.47 Typical High $549.54 | Professional | None | $134.90 | $245.47 | $549.54 |
Well Sense Setting Facility Modifier None Typical Low $91.20 Median $158.49 Typical High $239.88 | Facility | None | $91.20 | $158.49 | $239.88 |
Well Sense Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $165.96 | Professional | None | $93.33 | $112.20 | $165.96 |
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 $48.98 Median $74.13 Typical High $165.96 | Professional | 52 · Reduced service | $48.98 | $74.13 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $29.51 Typical High $66.07 | Professional | 53 · Discontinued | $19.50 | $29.51 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $109.65 Typical High $251.19 | Professional | 54 · Surgery only | $72.44 | $109.65 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $21.88 Typical High $50.12 | Professional | 55 · Aftercare only | $14.45 | $21.88 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.79 Typical High $33.11 | Professional | 56 · Pre-op care only | $9.77 | $14.79 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $102.33 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $67.61 | $102.33 | $234.42 |
Where Massachusetts sits
The same service costs 3.3 times more in Alaska than in Maryland. 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
$257
AK $490MD $148
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.