How much rates vary
Facilitymedian $166 · 10th to 90th $83 to $2,188Professionalmedian $229 · 10th to 90th $107 to $525
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 $436.52 Median $2,187.76 Typical High $3,630.78 | Facility | None | $436.52 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $288.40 | Professional | None | $83.18 | $125.89 | $288.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $75.86 Median $295.12 Typical High $1,862.09 | Facility | None | $75.86 | $295.12 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $114.82 Median $251.19 Typical High $1,202.26 | Professional | None | $114.82 | $251.19 | $1,202.26 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $234.42 | Facility | None | $100.00 | $100.00 | $234.42 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $100.00 Median $190.55 Typical High $338.84 | Professional | None | $100.00 | $190.55 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $144.54 Typical High $208.93 | Facility | None | $53.70 | $144.54 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $398.11 | Professional | None | $117.49 | $194.98 | $398.11 |
Fallon Health Setting Facility Modifier None Typical Low $93.33 Median $128.82 Typical High $3,311.31 | Facility | None | $93.33 | $128.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $288.40 | Professional | None | $208.93 | $245.47 | $288.40 |
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 $120.23 Median $234.42 Typical High $457.09 | Professional | None | $120.23 | $234.42 | $457.09 |
Health New England Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $275.42 | Professional | None | $151.36 | $229.09 | $275.42 |
Mass General Brigham Setting Facility Modifier None Typical Low $75.86 Median $295.12 Typical High $1,862.09 | Facility | None | $75.86 | $295.12 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $114.82 Median $251.19 Typical High $1,202.26 | Professional | None | $114.82 | $251.19 | $1,202.26 |
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 $114.82 Median $213.80 Typical High $478.63 | Professional | None | $114.82 | $213.80 | $478.63 |
Well Sense Setting Facility Modifier None Typical Low $75.86 Median $128.82 Typical High $194.98 | Facility | None | $75.86 | $128.82 | $194.98 |
Well Sense Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $141.25 | Professional | None | $81.28 | $97.72 | $141.25 |
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 $41.69 Median $63.10 Typical High $144.54 | Professional | 52 · Reduced service | $41.69 | $63.10 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $25.12 Typical High $57.54 | Professional | 53 · Discontinued | $16.60 | $25.12 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $93.33 Typical High $213.80 | Professional | 54 · Surgery only | $63.10 | $93.33 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.05 Typical High $42.66 | Professional | 55 · Aftercare only | $12.59 | $19.05 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.59 Typical High $28.84 | Professional | 56 · Pre-op care only | $8.32 | $12.59 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $87.10 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $58.88 | $87.10 | $199.53 |
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
$224
AK $427KY $123
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.