How much rates vary
Facilitymedian $933 · 10th to 90th $562 to $3,631Professionalmedian $1,230 · 10th to 90th $692 to $2,818
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 $1,949.84 Median $3,162.28 Typical High $8,709.64 | Facility | None | $1,949.84 | $3,162.28 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,819.70 | Professional | None | $588.84 | $741.31 | $1,819.70 |
AllWays Health Partners Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,630.78 | Facility | None | $489.78 | $1,258.93 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $645.65 Median $1,348.96 Typical High $6,918.31 | Professional | None | $645.65 | $1,348.96 | $6,918.31 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $1,479.11 | Facility | None | $645.65 | $645.65 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,230.27 Typical High $1,479.11 | Facility | None | $446.68 | $1,230.27 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,995.26 | Professional | None | $851.14 | $1,071.52 | $1,995.26 |
Fallon Health Setting Facility Modifier None Typical Low $630.96 Median $831.76 Typical High $3,311.31 | Facility | None | $630.96 | $831.76 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,174.90 | $1,380.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $5,128.61 | Facility | None | $549.54 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $724.44 Median $1,380.38 Typical High $2,398.83 | Professional | None | $724.44 | $1,380.38 | $2,398.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,630.78 | Facility | None | $489.78 | $1,258.93 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $645.65 Median $1,348.96 Typical High $6,918.31 | Professional | None | $645.65 | $1,348.96 | $6,918.31 |
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 $776.25 Median $1,071.52 Typical High $2,818.38 | Professional | None | $776.25 | $1,071.52 | $2,818.38 |
Well Sense Setting Facility Modifier None Typical Low $457.09 Median $724.44 Typical High $1,122.02 | Facility | None | $457.09 | $724.44 | $1,122.02 |
Well Sense Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $691.83 | Professional | None | $467.74 | $575.44 | $691.83 |
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 $288.40 Median $371.54 Typical High $912.01 | Professional | 52 · Reduced service | $288.40 | $371.54 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $147.91 Typical High $371.54 | Professional | 53 · Discontinued | $117.49 | $147.91 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $549.54 Typical High $1,380.38 | Professional | 54 · Surgery only | $436.52 | $549.54 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $109.65 Typical High $275.42 | Professional | 55 · Aftercare only | $87.10 | $109.65 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $74.13 Typical High $181.97 | Professional | 56 · Pre-op care only | $58.88 | $74.13 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $512.86 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $407.38 | $512.86 | $1,288.25 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $371.54 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $302.00 | $371.54 | $501.19 |
Where Massachusetts sits
The same service costs 5.6 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· 10th of 51
$1,202
AK $2,630TX $468
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.