How much rates vary
Facilitymedian $851 · 10th to 90th $257 to $2,818Professionalmedian $1,096 · 10th to 90th $676 to $4,786
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 $1,318.26 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,905.46 | Professional | None | $630.96 | $630.96 | $1,905.46 |
AllWays Health Partners Setting Facility Modifier None Typical Low $199.53 Median $794.33 Typical High $2,818.38 | Facility | None | $199.53 | $794.33 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $758.58 Median $1,479.11 Typical High $4,786.30 | Professional | None | $758.58 | $1,479.11 | $4,786.30 |
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 $933.25 Median $933.25 Typical High $1,862.09 | Professional | None | $933.25 | $933.25 | $1,862.09 |
Fallon Health Setting Facility Modifier None Typical Low $676.08 Median $912.01 Typical High $3,311.31 | Facility | None | $676.08 | $912.01 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,096.48 | Professional | None | $812.83 | $954.99 | $1,096.48 |
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 $794.33 Median $1,445.44 Typical High $2,187.76 | Professional | None | $794.33 | $1,445.44 | $2,187.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $199.53 Median $794.33 Typical High $2,818.38 | Facility | None | $199.53 | $794.33 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $758.58 Median $1,479.11 Typical High $4,786.30 | Professional | None | $758.58 | $1,479.11 | $4,786.30 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,630.78 | Facility | None | $123.03 | $549.54 | $3,630.78 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $3,090.30 | Professional | None | $776.25 | $1,071.52 | $3,090.30 |
Well Sense Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $1,047.13 | Facility | None | $446.68 | $616.60 | $1,047.13 |
Well Sense Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $645.65 | Professional | None | $478.63 | $478.63 | $645.65 |
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 $316.23 Median $316.23 Typical High $933.25 | Professional | 52 · Reduced service | $316.23 | $316.23 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $380.19 | Professional | 53 · Discontinued | $125.89 | $125.89 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $1,412.54 | Professional | 54 · Surgery only | $478.63 | $478.63 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $281.84 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $190.55 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $1,318.26 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $891.25 Typical High $3,090.30 | Professional | 54 · Surgery only | $741.31 | $891.25 | $3,090.30 |
Where Massachusetts sits
The same service costs 8.5 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· 14th of 51
$1,072
AK $2,818TX $331
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.