How much rates vary
Facilitymedian $251 · 10th to 90th $126 to $2,344Professionalmedian $324 · 10th to 90th $155 to $776
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 $616.60 Median $2,691.53 Typical High $3,715.35 | Facility | None | $616.60 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $407.38 | Professional | None | $120.23 | $177.83 | $407.38 |
AllWays Health Partners Setting Facility Modifier None Typical Low $123.03 Median $407.38 Typical High $1,862.09 | Facility | None | $123.03 | $407.38 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $169.82 Median $363.08 Typical High $1,737.80 | Professional | None | $169.82 | $363.08 | $1,737.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $338.84 | Facility | None | $144.54 | $144.54 | $338.84 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $478.63 | Professional | None | $144.54 | $269.15 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $489.78 | Facility | None | $199.53 | $275.42 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $575.44 | Professional | None | $169.82 | $275.42 | $575.44 |
Fallon Health Setting Facility Modifier None Typical Low $144.54 Median $186.21 Typical High $3,311.31 | Facility | None | $144.54 | $186.21 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $407.38 | Professional | None | $295.12 | $346.74 | $407.38 |
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 $173.78 Median $338.84 Typical High $660.69 | Professional | None | $173.78 | $338.84 | $660.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $123.03 Median $407.38 Typical High $1,862.09 | Facility | None | $123.03 | $407.38 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $169.82 Median $363.08 Typical High $1,737.80 | Professional | None | $169.82 | $363.08 | $1,737.80 |
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 $169.82 Median $302.00 Typical High $660.69 | Professional | None | $169.82 | $302.00 | $660.69 |
Well Sense Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $275.42 | Facility | None | $123.03 | $181.97 | $275.42 |
Well Sense Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $204.17 | Professional | None | $117.49 | $141.25 | $204.17 |
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 $60.26 Median $89.13 Typical High $204.17 | Professional | 52 · Reduced service | $60.26 | $89.13 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $35.48 Typical High $83.18 | Professional | 53 · Discontinued | $24.55 | $35.48 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $131.83 Typical High $309.03 | Professional | 54 · Surgery only | $91.20 | $131.83 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $26.92 Typical High $61.66 | Professional | 55 · Aftercare only | $18.20 | $26.92 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $17.78 Typical High $40.74 | Professional | 56 · Pre-op care only | $12.02 | $17.78 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $123.03 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $85.11 | $123.03 | $288.40 |
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
$324
AK $617KY $178
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.