How much rates vary
Facilitymedian $132 · 10th to 90th $48 to $2,570Professionalmedian $234 · 10th to 90th $58 to $741
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 $489.78 Median $2,187.76 Typical High $3,630.78 | Facility | None | $489.78 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $147.91 Typical High $213.80 | Professional | None | $47.86 | $147.91 | $213.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $35.48 Median $501.19 Typical High $2,344.23 | Facility | None | $35.48 | $501.19 | $2,344.23 |
AllWays Health Partners Setting Professional Modifier None Typical Low $57.54 Median $245.47 Typical High $2,344.23 | Professional | None | $57.54 | $245.47 | $2,344.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $112.20 | Facility | None | $47.86 | $47.86 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $2,691.53 | Facility | None | $831.76 | $831.76 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $190.55 Typical High $512.86 | Professional | None | $66.07 | $190.55 | $512.86 |
Fallon Health Setting Facility Modifier None Typical Low $52.48 Median $61.66 Typical High $3,311.31 | Facility | None | $52.48 | $61.66 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $371.54 | Professional | None | $275.42 | $316.23 | $371.54 |
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 $63.10 Median $218.78 Typical High $588.84 | Professional | None | $63.10 | $218.78 | $588.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $35.48 Median $501.19 Typical High $2,344.23 | Facility | None | $35.48 | $501.19 | $2,344.23 |
Mass General Brigham Setting Professional Modifier None Typical Low $57.54 Median $245.47 Typical High $2,344.23 | Professional | None | $57.54 | $245.47 | $2,344.23 |
United Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $2,818.38 | Facility | None | $117.49 | $537.03 | $2,818.38 |
United Setting Professional Modifier None Typical Low $64.57 Median $223.87 Typical High $630.96 | Professional | None | $64.57 | $223.87 | $630.96 |
Well Sense Setting Facility Modifier None Typical Low $43.65 Median $87.10 Typical High $275.42 | Facility | None | $43.65 | $87.10 | $275.42 |
Well Sense Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $144.54 | Professional | None | $38.02 | $51.29 | $144.54 |
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 $23.44 Median $74.13 Typical High $97.72 | Professional | 52 · Reduced service | $23.44 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $29.51 Typical High $38.90 | Professional | 53 · Discontinued | $9.55 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $112.20 Typical High $144.54 | Professional | 54 · Surgery only | $35.48 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $22.39 Typical High $28.84 | Professional | 55 · Aftercare only | $7.08 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $14.79 Typical High $19.50 | Professional | 56 · Pre-op care only | $4.68 | $14.79 | $19.50 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.59 Median $12.59 Typical High $17.38 | Professional | 80 · Assistant surgeon | $7.59 | $12.59 | $17.38 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $24.55 Median $36.31 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $24.55 | $36.31 | $104.71 |
Where Massachusetts sits
The same service costs 4.6 times more in Iowa than in Kentucky. 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· 7th of 51
$224
IA $288KY $63.10
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.