How much rates vary
Facilitymedian $447 · 10th to 90th $129 to $2,239Professionalmedian $537 · 10th to 90th $309 to $1,380
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 $776.25 Median $2,187.76 Typical High $3,630.78 | Facility | None | $776.25 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $812.83 | Professional | None | $275.42 | $309.03 | $812.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $93.33 Median $380.19 Typical High $1,862.09 | Facility | None | $93.33 | $380.19 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $309.03 Median $630.96 Typical High $2,754.23 | Professional | None | $309.03 | $630.96 | $2,754.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $363.08 Median $436.52 Typical High $831.76 | Facility | None | $363.08 | $436.52 | $831.76 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $831.76 | Professional | None | $363.08 | $436.52 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $295.12 Typical High $489.78 | Facility | None | $204.17 | $295.12 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $851.14 | Professional | None | $426.58 | $467.74 | $851.14 |
Fallon Health Setting Facility Modifier None Typical Low $354.81 Median $457.09 Typical High $3,311.31 | Facility | None | $354.81 | $457.09 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $645.65 | Professional | None | $478.63 | $562.34 | $645.65 |
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 $371.54 Median $707.95 Typical High $1,047.13 | Professional | None | $371.54 | $707.95 | $1,047.13 |
Health New England Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $354.81 | Facility | None | $295.12 | $295.12 | $354.81 |
Health New England Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Mass General Brigham Setting Facility Modifier None Typical Low $93.33 Median $380.19 Typical High $1,862.09 | Facility | None | $93.33 | $380.19 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $309.03 Median $630.96 Typical High $2,754.23 | Professional | None | $309.03 | $630.96 | $2,754.23 |
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 $338.84 Median $478.63 Typical High $1,380.38 | Professional | None | $338.84 | $478.63 | $1,380.38 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $309.03 Typical High $537.03 | Facility | None | $93.33 | $309.03 | $537.03 |
Well Sense Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $269.15 | Professional | None | $199.53 | $223.87 | $269.15 |
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 $138.04 Median $154.88 Typical High $389.05 | Professional | 52 · Reduced service | $138.04 | $154.88 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $154.88 | Professional | 53 · Discontinued | $54.95 | $61.66 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $588.84 | Professional | 54 · Surgery only | $208.93 | $229.09 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $117.49 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.90 Typical High $77.62 | Professional | 56 · Pre-op care only | $27.54 | $30.90 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $549.54 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $407.38 Typical High $1,288.25 | Professional | 54 · Surgery only | $257.04 | $407.38 | $1,288.25 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $141.25 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $128.82 | $141.25 | $194.98 |
Where Massachusetts sits
The same service costs 5.8 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· 10th of 51
$525
AK $1,259UT $219
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.