How much rates vary
Facilitymedian $229 · 10th to 90th $112 to $2,239Professionalmedian $282 · 10th to 90th $132 to $661
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $363.08 | Professional | None | $104.71 | $158.49 | $363.08 |
AllWays Health Partners Setting Facility Modifier None Typical Low $112.20 Median $389.05 Typical High $1,862.09 | Facility | None | $112.20 | $389.05 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $144.54 Median $316.23 Typical High $1,513.56 | Professional | None | $144.54 | $316.23 | $1,513.56 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $288.40 | Facility | None | $123.03 | $123.03 | $288.40 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $123.03 Median $239.88 Typical High $416.87 | Professional | None | $123.03 | $239.88 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $199.53 Typical High $257.04 | Facility | None | $53.70 | $199.53 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $489.78 | Professional | None | $147.91 | $245.47 | $489.78 |
Fallon Health Setting Facility Modifier None Typical Low $123.03 Median $162.18 Typical High $3,311.31 | Facility | None | $123.03 | $162.18 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $354.81 | Professional | None | $257.04 | $302.00 | $354.81 |
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 $151.36 Median $288.40 Typical High $575.44 | Professional | None | $151.36 | $288.40 | $575.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $112.20 Median $389.05 Typical High $1,862.09 | Facility | None | $112.20 | $389.05 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $144.54 Median $316.23 Typical High $1,513.56 | Professional | None | $144.54 | $316.23 | $1,513.56 |
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 $144.54 Median $269.15 Typical High $588.84 | Professional | None | $144.54 | $269.15 | $588.84 |
Well Sense Setting Facility Modifier None Typical Low $107.15 Median $158.49 Typical High $239.88 | Facility | None | $107.15 | $158.49 | $239.88 |
Well Sense Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $177.83 | Professional | None | $100.00 | $120.23 | $177.83 |
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 $51.29 Median $79.43 Typical High $177.83 | Professional | 52 · Reduced service | $51.29 | $79.43 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $31.62 Typical High $70.79 | Professional | 53 · Discontinued | $20.89 | $31.62 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $117.49 Typical High $269.15 | Professional | 54 · Surgery only | $77.62 | $117.49 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.44 Typical High $53.70 | Professional | 55 · Aftercare only | $15.49 | $23.44 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.85 Typical High $35.48 | Professional | 56 · Pre-op care only | $10.47 | $15.85 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $109.65 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $72.44 | $109.65 | $251.19 |
Where Massachusetts sits
The same service costs 3.5 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
$282
AK $525MD $151
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.