How much rates vary
Facilitymedian $490 · 10th to 90th $186 to $2,884Professionalmedian $389 · 10th to 90th $200 to $977
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 $165.96 Median $257.04 Typical High $501.19 | Professional | None | $165.96 | $257.04 | $501.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $2,884.03 | Facility | None | $338.84 | $851.14 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier None Typical Low $204.17 Median $436.52 Typical High $2,041.74 | Professional | None | $204.17 | $436.52 | $2,041.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $407.38 | Facility | None | $181.97 | $218.78 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,445.44 | Facility | None | $446.68 | $977.24 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $676.08 | Professional | None | $234.42 | $371.54 | $676.08 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $234.42 Typical High $3,311.31 | Facility | None | $177.83 | $234.42 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $478.63 | Professional | None | $363.08 | $416.87 | $478.63 |
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 $208.93 Median $416.87 Typical High $812.83 | Professional | None | $208.93 | $416.87 | $812.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $2,884.03 | Facility | None | $338.84 | $851.14 | $2,884.03 |
Mass General Brigham Setting Professional Modifier None Typical Low $204.17 Median $436.52 Typical High $2,041.74 | Professional | None | $204.17 | $436.52 | $2,041.74 |
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 $218.78 Median $371.54 Typical High $812.83 | Professional | None | $218.78 | $371.54 | $812.83 |
Well Sense Setting Facility Modifier None Typical Low $158.49 Median $275.42 Typical High $489.78 | Facility | None | $158.49 | $275.42 | $489.78 |
Well Sense Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $234.42 | Professional | None | $128.82 | $173.78 | $234.42 |
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 $83.18 Median $128.82 Typical High $251.19 | Professional | 52 · Reduced service | $83.18 | $128.82 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $51.29 Typical High $100.00 | Professional | 53 · Discontinued | $33.11 | $51.29 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $194.98 Typical High $371.54 | Professional | 54 · Surgery only | $123.03 | $194.98 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $38.90 Typical High $75.86 | Professional | 55 · Aftercare only | $24.55 | $38.90 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $25.70 Typical High $50.12 | Professional | 56 · Pre-op care only | $16.60 | $25.70 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $181.97 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $114.82 | $181.97 | $346.74 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $123.03 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $81.28 | $123.03 | $165.96 |
Where Massachusetts sits
The same service costs 4.1 times more in Alaska than in Texas. 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
$389
AK $851TX $209
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.