How much rates vary
Facilitymedian $891 · 10th to 90th $347 to $5,370Professionalmedian $661 · 10th to 90th $347 to $1,585
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 $1,023.29 Median $2,818.38 Typical High $4,677.35 | Facility | None | $1,023.29 | $2,818.38 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $912.01 | Professional | None | $338.84 | $467.74 | $912.01 |
AllWays Health Partners Setting Facility Modifier None Typical Low $575.44 Median $1,905.46 Typical High $5,888.44 | Facility | None | $575.44 | $1,905.46 | $5,888.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $346.74 Median $758.58 Typical High $3,311.31 | Professional | None | $346.74 | $758.58 | $3,311.31 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $758.58 | Facility | None | $338.84 | $407.38 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,949.84 Typical High $2,818.38 | Facility | None | $676.08 | $1,949.84 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $1,122.02 | Professional | None | $436.52 | $602.56 | $1,122.02 |
Fallon Health Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $3,311.31 | Facility | None | $331.13 | $436.52 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $776.25 | Professional | None | $575.44 | $660.69 | $776.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $363.08 Median $741.31 Typical High $1,348.96 | Professional | None | $363.08 | $741.31 | $1,348.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $575.44 Median $1,905.46 Typical High $5,888.44 | Facility | None | $575.44 | $1,905.46 | $5,888.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $346.74 Median $758.58 Typical High $3,311.31 | Professional | None | $346.74 | $758.58 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $10,964.78 | Facility | None | $1,071.52 | $3,467.37 | $10,964.78 |
United Setting Professional Modifier None Typical Low $380.19 Median $602.56 Typical High $1,445.44 | Professional | None | $380.19 | $602.56 | $1,445.44 |
Well Sense Setting Facility Modifier None Typical Low $302.00 Median $478.63 Typical High $977.24 | Facility | None | $302.00 | $478.63 | $977.24 |
Well Sense Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $380.19 | Professional | None | $234.42 | $316.23 | $380.19 |
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 $169.82 Median $229.09 Typical High $457.09 | Professional | 52 · Reduced service | $169.82 | $229.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $93.33 Typical High $181.97 | Professional | 53 · Discontinued | $67.61 | $93.33 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $346.74 Typical High $676.08 | Professional | 54 · Surgery only | $251.19 | $346.74 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $69.18 Typical High $138.04 | Professional | 55 · Aftercare only | $50.12 | $69.18 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $46.77 Typical High $91.20 | Professional | 56 · Pre-op care only | $33.88 | $46.77 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $323.59 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $234.42 | $323.59 | $630.96 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $204.17 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $151.36 | $204.17 | $275.42 |
Where Massachusetts sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$661
AK $1,622UT $324
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.