How much rates vary
Facilitymedian $224 · 10th to 90th $85 to $3,311Professionalmedian $186 · 10th to 90th $95 to $427
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 $338.84 Median $2,187.76 Typical High $3,630.78 | Facility | None | $338.84 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $269.15 | Professional | None | $79.43 | $97.72 | $269.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $177.83 Median $1,071.52 Typical High $3,630.78 | Facility | None | $177.83 | $1,071.52 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $95.50 Median $218.78 Typical High $1,479.11 | Professional | None | $95.50 | $218.78 | $1,479.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $218.78 | Facility | None | $95.50 | $95.50 | $218.78 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $263.03 | Professional | None | $95.50 | $151.36 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $151.36 Typical High $199.53 | Facility | None | $53.70 | $151.36 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $302.00 | Professional | None | $120.23 | $169.82 | $302.00 |
Fallon Health Setting Facility Modifier None Typical Low $93.33 Median $120.23 Typical High $3,311.31 | Facility | None | $93.33 | $120.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $223.87 | Professional | None | $165.96 | $194.98 | $223.87 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $389.05 | Professional | None | $112.20 | $208.93 | $389.05 |
Mass General Brigham Setting Facility Modifier None Typical Low $177.83 Median $1,071.52 Typical High $3,630.78 | Facility | None | $177.83 | $1,071.52 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $95.50 Median $218.78 Typical High $1,479.11 | Professional | None | $95.50 | $218.78 | $1,479.11 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,165.95 | Facility | None | $575.44 | $1,380.38 | $6,165.95 |
United Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $389.05 | Professional | None | $114.82 | $169.82 | $389.05 |
Well Sense Setting Facility Modifier None Typical Low $56.23 Median $97.72 Typical High $154.88 | Facility | None | $56.23 | $97.72 | $154.88 |
Well Sense Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $97.72 | Professional | None | $66.07 | $83.18 | $97.72 |
7 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 $39.81 Median $48.98 Typical High $134.90 | Professional | 52 · Reduced service | $39.81 | $48.98 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.50 Typical High $53.70 | Professional | 53 · Discontinued | $15.85 | $19.50 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $74.13 Typical High $204.17 | Professional | 54 · Surgery only | $58.88 | $74.13 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.79 Typical High $40.74 | Professional | 55 · Aftercare only | $11.75 | $14.79 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.77 Typical High $26.92 | Professional | 56 · Pre-op care only | $7.94 | $9.77 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $69.18 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $54.95 | $69.18 | $190.55 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $52.48 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $42.66 | $52.48 | $70.79 |
Where Massachusetts sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 10th of 51
$186
AK $363FL $91.20
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.