How much rates vary
Facilitymedian $603 · 10th to 90th $245 to $3,311Professionalmedian $537 · 10th to 90th $288 to $1,202
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 $758.58 Median $2,691.53 Typical High $3,715.35 | Facility | None | $758.58 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $758.58 | Professional | None | $239.88 | $389.05 | $758.58 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $1,348.96 Typical High $3,981.07 | Facility | None | $549.54 | $1,348.96 | $3,981.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $316.23 Median $630.96 Typical High $2,818.38 | Professional | None | $316.23 | $630.96 | $2,818.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $616.60 | Facility | None | $275.42 | $275.42 | $616.60 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $758.58 | Professional | None | $275.42 | $446.68 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $512.86 Typical High $831.76 | Facility | None | $363.08 | $512.86 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $954.99 | Professional | None | $338.84 | $512.86 | $954.99 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $331.13 Typical High $3,311.31 | Facility | None | $177.83 | $331.13 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $660.69 | Professional | None | $489.78 | $562.34 | $660.69 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $316.23 Median $630.96 Typical High $1,122.02 | Professional | None | $316.23 | $630.96 | $1,122.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $1,348.96 Typical High $3,981.07 | Facility | None | $549.54 | $1,348.96 | $3,981.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $316.23 Median $630.96 Typical High $2,818.38 | Professional | None | $316.23 | $630.96 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $6,309.57 | Facility | None | $1,047.13 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $1,148.15 | Professional | None | $323.59 | $524.81 | $1,148.15 |
Well Sense Setting Facility Modifier None Typical Low $208.93 Median $295.12 Typical High $446.68 | Facility | None | $208.93 | $295.12 | $446.68 |
Well Sense Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $331.13 | Professional | None | $190.55 | $257.04 | $331.13 |
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 $120.23 Median $194.98 Typical High $380.19 | Professional | 52 · Reduced service | $120.23 | $194.98 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $77.62 Typical High $151.36 | Professional | 53 · Discontinued | $47.86 | $77.62 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $288.40 Typical High $575.44 | Professional | 54 · Surgery only | $177.83 | $288.40 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $57.54 Typical High $114.82 | Professional | 55 · Aftercare only | $36.31 | $57.54 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $38.90 Typical High $75.86 | Professional | 56 · Pre-op care only | $23.99 | $38.90 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $269.15 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $165.96 | $269.15 | $537.03 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $177.83 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $120.23 | $177.83 | $239.88 |
Where Massachusetts sits
The same service costs 4.3 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· 10th of 51
$537
AK $1,023TX $240
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.