How much rates vary
Facilitymedian $490 · 10th to 90th $170 to $3,311Professionalmedian $372 · 10th to 90th $174 to $933
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $446.68 | Professional | None | $147.91 | $251.19 | $446.68 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $1,096.48 Typical High $3,311.31 | Facility | None | $354.81 | $1,096.48 | $3,311.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $177.83 Median $398.11 Typical High $2,041.74 | Professional | None | $177.83 | $398.11 | $2,041.74 |
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 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $977.24 Typical High $1,445.44 | Facility | None | $199.53 | $977.24 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $616.60 | Professional | None | $208.93 | $363.08 | $616.60 |
Fallon Health Setting Facility Modifier None Typical Low $162.18 Median $213.80 Typical High $3,311.31 | Facility | None | $162.18 | $213.80 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $478.63 | Professional | None | $354.81 | $416.87 | $478.63 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $190.55 Median $380.19 Typical High $776.25 | Professional | None | $190.55 | $380.19 | $776.25 |
Health New England Setting Facility Modifier None Typical Low $2,089.30 Median $3,090.30 Typical High $3,311.31 | Facility | None | $2,089.30 | $3,090.30 | $3,311.31 |
Health New England Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | None | $323.59 | $323.59 | $331.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $1,096.48 Typical High $3,311.31 | Facility | None | $354.81 | $1,096.48 | $3,311.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $177.83 Median $398.11 Typical High $2,041.74 | Professional | None | $177.83 | $398.11 | $2,041.74 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,456.54 | Facility | None | $575.44 | $1,380.38 | $6,456.54 |
United Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $794.33 | Professional | None | $194.98 | $354.81 | $794.33 |
Well Sense Setting Facility Modifier None Typical Low $141.25 Median $269.15 Typical High $575.44 | Facility | None | $141.25 | $269.15 | $575.44 |
Well Sense Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $223.87 | Professional | None | $114.82 | $154.88 | $223.87 |
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 $74.13 Median $125.89 Typical High $223.87 | Professional | 52 · Reduced service | $74.13 | $125.89 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $50.12 Typical High $89.13 | Professional | 53 · Discontinued | $29.51 | $50.12 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $190.55 Typical High $338.84 | Professional | 54 · Surgery only | $109.65 | $190.55 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $38.02 Typical High $67.61 | Professional | 55 · Aftercare only | $21.88 | $38.02 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $25.12 Typical High $44.67 | Professional | 56 · Pre-op care only | $14.79 | $25.12 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $177.83 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $102.33 | $177.83 | $316.23 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $109.65 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $74.13 | $109.65 | $162.18 |
Where Massachusetts sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 9th of 51
$372
AK $759KY $170
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.