How much rates vary
Facilitymedian $224 · 10th to 90th $110 to $2,188Professionalmedian $288 · 10th to 90th $138 to $676
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 $109.65 Median $158.49 Typical High $371.54 | Professional | None | $109.65 | $158.49 | $371.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $109.65 Median $389.05 Typical High $1,862.09 | Facility | None | $109.65 | $389.05 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $151.36 Median $323.59 Typical High $1,513.56 | Professional | None | $151.36 | $323.59 | $1,513.56 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $302.00 | Facility | None | $128.82 | $128.82 | $302.00 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $416.87 | Professional | None | $128.82 | $239.88 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $199.53 Typical High $251.19 | Facility | None | $53.70 | $199.53 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $512.86 | Professional | None | $151.36 | $245.47 | $512.86 |
Fallon Health Setting Facility Modifier None Typical Low $117.49 Median $162.18 Typical High $3,311.31 | Facility | None | $117.49 | $162.18 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $363.08 | Professional | None | $257.04 | $302.00 | $363.08 |
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 $154.88 Median $302.00 Typical High $588.84 | Professional | None | $154.88 | $302.00 | $588.84 |
Health New England Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | None | $288.40 | $288.40 | $302.00 |
Mass General Brigham Setting Facility Modifier None Typical Low $109.65 Median $389.05 Typical High $1,862.09 | Facility | None | $109.65 | $389.05 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $151.36 Median $323.59 Typical High $1,513.56 | Professional | None | $151.36 | $323.59 | $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 $147.91 Median $275.42 Typical High $588.84 | Professional | None | $147.91 | $275.42 | $588.84 |
Well Sense Setting Facility Modifier None Typical Low $109.65 Median $162.18 Typical High $245.47 | Facility | None | $109.65 | $162.18 | $245.47 |
Well Sense Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $181.97 | Professional | None | $104.71 | $125.89 | $181.97 |
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 $54.95 Median $79.43 Typical High $186.21 | Professional | 52 · Reduced service | $54.95 | $79.43 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $31.62 Typical High $74.13 | Professional | 53 · Discontinued | $21.88 | $31.62 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $120.23 Typical High $281.84 | Professional | 54 · Surgery only | $81.28 | $120.23 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $23.99 Typical High $56.23 | Professional | 55 · Aftercare only | $16.22 | $23.99 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.85 Typical High $37.15 | Professional | 56 · Pre-op care only | $10.96 | $15.85 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $112.20 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $75.86 | $112.20 | $263.03 |
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· 8th of 51
$288
AK $550MD $158
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.