How much rates vary
Facilitymedian $355 · 10th to 90th $145 to $2,692Professionalmedian $324 · 10th to 90th $148 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 $251.19 Median $2,570.40 Typical High $3,630.78 | Facility | None | $251.19 | $2,570.40 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $251.19 Typical High $389.05 | Professional | None | $125.89 | $251.19 | $389.05 |
AllWays Health Partners Setting Facility Modifier None Typical Low $275.42 Median $707.95 Typical High $2,089.30 | Facility | None | $275.42 | $707.95 | $2,089.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $151.36 Median $363.08 Typical High $1,949.84 | Professional | None | $151.36 | $363.08 | $1,949.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $331.13 | Facility | None | $144.54 | $177.83 | $331.13 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $144.54 Median $281.84 Typical High $489.78 | Professional | None | $144.54 | $281.84 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $489.78 | Facility | None | $199.53 | $316.23 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $575.44 | Professional | None | $177.83 | $323.59 | $575.44 |
Fallon Health Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $3,311.31 | Facility | None | $131.83 | $181.97 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $416.87 | Professional | None | $316.23 | $363.08 | $416.87 |
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 $165.96 Median $346.74 Typical High $676.08 | Professional | None | $165.96 | $346.74 | $676.08 |
Health New England Setting Facility Modifier None Typical Low $158.49 Median $630.96 Typical High $4,570.88 | Facility | None | $158.49 | $630.96 | $4,570.88 |
Health New England Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $457.09 | Professional | None | $199.53 | $346.74 | $457.09 |
Mass General Brigham Setting Facility Modifier None Typical Low $275.42 Median $707.95 Typical High $2,089.30 | Facility | None | $275.42 | $707.95 | $2,089.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $151.36 Median $363.08 Typical High $1,949.84 | Professional | None | $151.36 | $363.08 | $1,949.84 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $707.95 | Professional | None | $173.78 | $346.74 | $707.95 |
Well Sense Setting Facility Modifier None Typical Low $120.23 Median $173.78 Typical High $295.12 | Facility | None | $120.23 | $173.78 | $295.12 |
Well Sense Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $213.80 | Professional | None | $97.72 | $131.83 | $213.80 |
9 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 $63.10 Median $125.89 Typical High $194.98 | Professional | 52 · Reduced service | $63.10 | $125.89 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $50.12 Typical High $77.62 | Professional | 53 · Discontinued | $25.12 | $50.12 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $190.55 Typical High $295.12 | Professional | 54 · Surgery only | $93.33 | $190.55 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $38.02 Typical High $58.88 | Professional | 55 · Aftercare only | $19.05 | $38.02 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $25.12 Typical High $38.90 | Professional | 56 · Pre-op care only | $12.59 | $25.12 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $177.83 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $87.10 | $177.83 | $275.42 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $141.25 Typical High $251.19 | Professional | 52 · Reduced service | $141.25 | $141.25 | $251.19 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $151.36 Typical High $239.88 | Professional | 54 · Surgery only | $97.72 | $151.36 | $239.88 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $93.33 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $63.10 | $93.33 | $151.36 |
Where Massachusetts sits
The same service costs 3.6 times more in Alaska 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· 8th of 51
$324
AK $617KY $170
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.