How much rates vary
Facilitymedian $603 · 10th to 90th $282 to $3,311Professionalmedian $417 · 10th to 90th $219 to $1,096
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 $602.56 Median $2,187.76 Typical High $3,630.78 | Facility | None | $602.56 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $602.56 | Professional | None | $218.78 | $218.78 | $602.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $338.84 Median $1,071.52 Typical High $3,311.31 | Facility | None | $338.84 | $1,071.52 | $3,311.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $1,995.26 | Professional | None | $263.03 | $467.74 | $1,995.26 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $288.40 Median $346.74 Typical High $660.69 | Facility | None | $288.40 | $346.74 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $1,659.59 | Facility | None | $446.68 | $1,148.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $676.08 | Professional | None | $338.84 | $346.74 | $676.08 |
Fallon Health Setting Facility Modifier None Typical Low $281.84 Median $371.54 Typical High $3,311.31 | Facility | None | $281.84 | $371.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $467.74 | Professional | None | $354.81 | $407.38 | $467.74 |
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 $295.12 Median $562.34 Typical High $851.14 | Professional | None | $295.12 | $562.34 | $851.14 |
Mass General Brigham Setting Facility Modifier None Typical Low $338.84 Median $1,071.52 Typical High $3,311.31 | Facility | None | $338.84 | $1,071.52 | $3,311.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $1,995.26 | Professional | None | $263.03 | $467.74 | $1,995.26 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,309.57 | Facility | None | $575.44 | $1,380.38 | $6,309.57 |
United Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $1,096.48 | Professional | None | $245.47 | $371.54 | $1,096.48 |
Well Sense Setting Facility Modifier None Typical Low $186.21 Median $275.42 Typical High $602.56 | Facility | None | $186.21 | $275.42 | $602.56 |
Well Sense Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $208.93 | Professional | None | $154.88 | $158.49 | $208.93 |
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 $109.65 Median $109.65 Typical High $302.00 | Professional | 52 · Reduced service | $109.65 | $109.65 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $44.67 Typical High $120.23 | Professional | 53 · Discontinued | $43.65 | $44.67 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $165.96 Typical High $457.09 | Professional | 54 · Surgery only | $162.18 | $165.96 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.11 Typical High $91.20 | Professional | 55 · Aftercare only | $32.36 | $33.11 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $154.88 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $151.36 | $154.88 | $426.58 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $100.00 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $100.00 | $100.00 | $151.36 |
Where Massachusetts sits
The same service costs 5.4 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· 11th of 51
$417
AK $1,023UT $191
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.