How much rates vary
Facilitymedian $912 · 10th to 90th $389 to $4,266Professionalmedian $724 · 10th to 90th $407 to $1,778
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 $1,122.02 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,122.02 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $1,122.02 | Professional | None | $398.11 | $501.19 | $1,122.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $1,819.70 Typical High $5,128.61 | Facility | None | $457.09 | $1,819.70 | $5,128.61 |
AllWays Health Partners Setting Professional Modifier None Typical Low $389.05 Median $812.83 Typical High $3,548.13 | Professional | None | $389.05 | $812.83 | $3,548.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $389.05 Median $467.74 Typical High $891.25 | Facility | None | $389.05 | $467.74 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,949.84 Typical High $2,818.38 | Facility | None | $588.84 | $1,949.84 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $1,174.90 | Professional | None | $489.78 | $630.96 | $1,174.90 |
Fallon Health Setting Facility Modifier None Typical Low $380.19 Median $501.19 Typical High $3,311.31 | Facility | None | $380.19 | $501.19 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $831.76 | Professional | None | $616.60 | $724.44 | $831.76 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $446.68 Median $831.76 Typical High $1,445.44 | Professional | None | $446.68 | $831.76 | $1,445.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $1,819.70 Typical High $5,128.61 | Facility | None | $457.09 | $1,819.70 | $5,128.61 |
Mass General Brigham Setting Professional Modifier None Typical Low $389.05 Median $812.83 Typical High $3,548.13 | Professional | None | $389.05 | $812.83 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $1,778.28 | Professional | None | $457.09 | $691.83 | $1,778.28 |
Well Sense Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $891.25 | Facility | None | $331.13 | $501.19 | $891.25 |
Well Sense Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $436.52 | Professional | None | $295.12 | $363.08 | $436.52 |
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 $199.53 Median $251.19 Typical High $562.34 | Professional | 52 · Reduced service | $199.53 | $251.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $100.00 Typical High $229.09 | Professional | 53 · Discontinued | $79.43 | $100.00 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $380.19 Typical High $851.14 | Professional | 54 · Surgery only | $302.00 | $380.19 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $75.86 Typical High $169.82 | Professional | 55 · Aftercare only | $60.26 | $75.86 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $50.12 Typical High $112.20 | Professional | 56 · Pre-op care only | $39.81 | $50.12 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $354.81 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $281.84 | $354.81 | $794.33 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $234.42 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $186.21 | $234.42 | $316.23 |
Where Massachusetts sits
The same service costs 6.0 times more in Alaska than in Texas. 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
$741
AK $1,778TX $295
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.