How much rates vary
Facilitymedian $363 · 10th to 90th $145 to $3,090Professionalmedian $302 · 10th to 90th $162 to $724
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 $549.54 Median $2,691.53 Typical High $3,715.35 | Facility | None | $549.54 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $398.11 | Professional | None | $138.04 | $194.98 | $398.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $275.42 Median $851.14 Typical High $2,884.03 | Facility | None | $275.42 | $851.14 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $165.96 Median $363.08 Typical High $1,698.24 | Professional | None | $165.96 | $363.08 | $1,698.24 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $162.18 Median $199.53 Typical High $371.54 | Facility | None | $162.18 | $199.53 | $371.54 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $467.74 | Professional | None | $162.18 | $275.42 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $302.00 Typical High $489.78 | Facility | None | $199.53 | $302.00 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $549.54 | Professional | None | $199.53 | $295.12 | $549.54 |
Fallon Health Setting Facility Modifier None Typical Low $144.54 Median $204.17 Typical High $3,311.31 | Facility | None | $144.54 | $204.17 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $407.38 | Professional | None | $302.00 | $346.74 | $407.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $173.78 Median $354.81 Typical High $660.69 | Professional | None | $173.78 | $354.81 | $660.69 |
Health New England Setting Facility Modifier None Typical Low $281.84 Median $575.44 Typical High $2,041.74 | Facility | None | $281.84 | $575.44 | $2,041.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $275.42 Median $851.14 Typical High $2,884.03 | Facility | None | $275.42 | $851.14 | $2,884.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $165.96 Median $363.08 Typical High $1,698.24 | Professional | None | $165.96 | $363.08 | $1,698.24 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $5,370.32 | Facility | None | $407.38 | $870.96 | $5,370.32 |
United Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $676.08 | Professional | None | $186.21 | $288.40 | $676.08 |
Well Sense Setting Facility Modifier None Typical Low $117.49 Median $169.82 Typical High $257.04 | Facility | None | $117.49 | $169.82 | $257.04 |
Well Sense Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $165.96 | Professional | None | $102.33 | $138.04 | $165.96 |
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 $69.18 Median $97.72 Typical High $199.53 | Professional | 52 · Reduced service | $69.18 | $97.72 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.90 Typical High $79.43 | Professional | 53 · Discontinued | $27.54 | $38.90 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $144.54 Typical High $302.00 | Professional | 54 · Surgery only | $102.33 | $144.54 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $28.84 Typical High $60.26 | Professional | 55 · Aftercare only | $20.42 | $28.84 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.50 Typical High $39.81 | Professional | 56 · Pre-op care only | $13.80 | $19.50 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $134.90 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $95.50 | $134.90 | $281.84 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $89.13 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $66.07 | $89.13 | $120.23 |
Where Massachusetts sits
The same service costs 3.5 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
$302
AK $603FL $174
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.