How much rates vary
Facilitymedian $372 · 10th to 90th $158 to $2,884Professionalmedian $363 · 10th to 90th $174 to $912
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 $245.47 Typical High $446.68 | Professional | None | $147.91 | $245.47 | $446.68 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $851.14 Typical High $2,884.03 | Facility | None | $323.59 | $851.14 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $173.78 Median $389.05 Typical High $1,949.84 | Professional | None | $173.78 | $389.05 | $1,949.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $162.18 Median $194.98 Typical High $371.54 | Facility | None | $162.18 | $194.98 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $346.74 Typical High $489.78 | Facility | None | $199.53 | $346.74 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $630.96 | Professional | None | $204.17 | $346.74 | $630.96 |
Fallon Health Setting Facility Modifier None Typical Low $158.49 Median $208.93 Typical High $3,311.31 | Facility | None | $158.49 | $208.93 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $467.74 | Professional | None | $346.74 | $398.11 | $467.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $177.83 Median $371.54 Typical High $741.31 | Professional | None | $177.83 | $371.54 | $741.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $851.14 Typical High $2,884.03 | Facility | None | $323.59 | $851.14 | $2,884.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $173.78 Median $389.05 Typical High $1,949.84 | Professional | None | $173.78 | $389.05 | $1,949.84 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $5,370.32 | Facility | None | $407.38 | $870.96 | $5,370.32 |
United Setting Professional Modifier None Typical Low $177.83 Median $346.74 Typical High $758.58 | Professional | None | $177.83 | $346.74 | $758.58 |
Well Sense Setting Facility Modifier None Typical Low $131.83 Median $199.53 Typical High $302.00 | Facility | None | $131.83 | $199.53 | $302.00 |
Well Sense Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $223.87 | Professional | None | $117.49 | $158.49 | $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 $123.03 Typical High $223.87 | Professional | 52 · Reduced service | $74.13 | $123.03 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $48.98 Typical High $89.13 | Professional | 53 · Discontinued | $30.20 | $48.98 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $186.21 Typical High $338.84 | Professional | 54 · Surgery only | $112.20 | $186.21 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $37.15 Typical High $67.61 | Professional | 55 · Aftercare only | $22.39 | $37.15 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $24.55 Typical High $44.67 | Professional | 56 · Pre-op care only | $14.79 | $24.55 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $173.78 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $104.71 | $173.78 | $316.23 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $112.20 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $74.13 | $112.20 | $162.18 |
Where Massachusetts sits
The same service costs 4.4 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· 8th of 51
$363
AK $661KY $151
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.