How much rates vary
Facilitymedian $617 · 10th to 90th $117 to $3,548Professionalmedian $200 · 10th to 90th $112 to $1,698
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 $1,318.26 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | None | $112.20 | $112.20 | $141.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $117.49 Median $501.19 Typical High $2,344.23 | Facility | None | $117.49 | $501.19 | $2,344.23 |
AllWays Health Partners Setting Professional Modifier None Typical Low $117.49 Median $281.84 Typical High $1,698.24 | Professional | None | $117.49 | $281.84 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,380.38 Typical High $13,489.63 | Facility | None | $676.08 | $1,380.38 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $309.03 | Professional | None | $154.88 | $154.88 | $309.03 |
Fallon Health Setting Facility Modifier None Typical Low $162.18 Median $190.55 Typical High $1,096.48 | Facility | None | $162.18 | $190.55 | $1,096.48 |
Fallon Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | None | $162.18 | $162.18 | $190.55 |
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 $141.25 Median $263.03 Typical High $371.54 | Professional | None | $141.25 | $263.03 | $371.54 |
Health New England Setting Facility Modifier None Typical Low $3,890.45 Median $5,370.32 Typical High $11,481.54 | Facility | None | $3,890.45 | $5,370.32 | $11,481.54 |
Health New England Setting Professional Modifier None Typical Low $177.83 Median $1,949.84 Typical High $1,949.84 | Professional | None | $177.83 | $1,949.84 | $1,949.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $117.49 Median $501.19 Typical High $2,344.23 | Facility | None | $117.49 | $501.19 | $2,344.23 |
Mass General Brigham Setting Professional Modifier None Typical Low $117.49 Median $281.84 Typical High $1,698.24 | Professional | None | $117.49 | $281.84 | $1,698.24 |
United Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $2,818.38 | Facility | None | $117.49 | $537.03 | $2,818.38 |
United Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $537.03 | Professional | None | $123.03 | $181.97 | $537.03 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,467.37 | $5,128.61 |
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 $56.23 Median $56.23 Typical High $66.07 | Professional | 52 · Reduced service | $56.23 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $26.92 | Professional | 53 · Discontinued | $22.39 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | 54 · Surgery only | $85.11 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $19.95 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $13.18 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $173.78 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $107.15 | $173.78 | $245.47 |
Well Sense Setting Professional Modifier 58 · Staged procedure + 76 · Repeat, same provider Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 58 · Staged procedure + 76 · Repeat, same provider | $1,995.26 | $1,995.26 | $1,995.26 |
Where Massachusetts sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 11th of 51
$209
AK $468DE $117
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.