How much rates vary
Facilitymedian $135 · 10th to 90th $66 to $1,862Professionalmedian $158 · 10th to 90th $87 to $355
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 $87.10 Median $2,691.53 Typical High $5,128.61 | Facility | None | $87.10 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $234.42 | Professional | None | $87.10 | $131.83 | $234.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $52.48 Median $309.03 Typical High $1,862.09 | Facility | None | $52.48 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $83.18 Median $177.83 Typical High $1,047.13 | Professional | None | $83.18 | $177.83 | $1,047.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $81.28 Median $97.72 Typical High $186.21 | Facility | None | $81.28 | $97.72 | $186.21 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $208.93 | Professional | None | $81.28 | $123.03 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $489.78 | Facility | None | $93.33 | $114.82 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $263.03 | Professional | None | $104.71 | $141.25 | $263.03 |
Fallon Health Setting Facility Modifier None Typical Low $81.28 Median $104.71 Typical High $3,311.31 | Facility | None | $81.28 | $104.71 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $181.97 | Professional | None | $134.90 | $154.88 | $181.97 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $95.50 Median $181.97 Typical High $316.23 | Professional | None | $95.50 | $181.97 | $316.23 |
Health New England Setting Facility Modifier None Typical Low $165.96 Median $251.19 Typical High $588.84 | Facility | None | $165.96 | $251.19 | $588.84 |
Health New England Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $194.98 | Professional | None | $147.91 | $186.21 | $194.98 |
Mass General Brigham Setting Facility Modifier None Typical Low $52.48 Median $309.03 Typical High $1,862.09 | Facility | None | $52.48 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $83.18 Median $177.83 Typical High $1,047.13 | Professional | None | $83.18 | $177.83 | $1,047.13 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $354.81 | Professional | None | $102.33 | $147.91 | $354.81 |
Well Sense Setting Facility Modifier None Typical Low $47.86 Median $89.13 Typical High $141.25 | Facility | None | $47.86 | $89.13 | $141.25 |
Well Sense Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $104.71 | Professional | None | $61.66 | $83.18 | $104.71 |
8 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 $43.65 Median $66.07 Typical High $117.49 | Professional | 52 · Reduced service | $43.65 | $66.07 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $26.30 Typical High $46.77 | Professional | 53 · Discontinued | $17.38 | $26.30 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $100.00 Typical High $173.78 | Professional | 54 · Surgery only | $66.07 | $100.00 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.95 Typical High $35.48 | Professional | 55 · Aftercare only | $13.18 | $19.95 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $13.18 Typical High $23.44 | Professional | 56 · Pre-op care only | $8.71 | $13.18 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $93.33 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $61.66 | $93.33 | $162.18 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $97.72 Typical High $338.84 | Professional | 54 · Surgery only | $67.61 | $97.72 | $338.84 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $54.95 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $38.90 | $54.95 | $74.13 |
Where Massachusetts sits
The same service costs 3.9 times more in Alaska than in Florida. 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
$158
AK $324FL $83.18
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.