How much rates vary
Facilitymedian $200 · 10th to 90th $72 to $2,344Professionalmedian $209 · 10th to 90th $120 to $550
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 $331.13 Median $2,187.76 Typical High $3,630.78 | Facility | None | $331.13 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $331.13 | Professional | None | $117.49 | $120.23 | $331.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $66.07 Median $363.08 Typical High $1,862.09 | Facility | None | $66.07 | $363.08 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $977.24 | Professional | None | $131.83 | $263.03 | $977.24 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $275.42 | Professional | None | $154.88 | $154.88 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $117.49 Typical High $169.82 | Facility | None | $53.70 | $117.49 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $363.08 | Professional | None | $169.82 | $186.21 | $363.08 |
Fallon Health Setting Facility Modifier None Typical Low $131.83 Median $177.83 Typical High $3,311.31 | Facility | None | $131.83 | $177.83 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $229.09 | Professional | None | $169.82 | $199.53 | $229.09 |
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 $151.36 Median $281.84 Typical High $407.38 | Professional | None | $151.36 | $281.84 | $407.38 |
Health New England Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Health New England Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $218.78 | Professional | None | $131.83 | $218.78 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $66.07 Median $363.08 Typical High $1,862.09 | Facility | None | $66.07 | $363.08 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $977.24 | Professional | None | $131.83 | $263.03 | $977.24 |
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 $138.04 Median $199.53 Typical High $549.54 | Professional | None | $138.04 | $199.53 | $549.54 |
Well Sense Setting Facility Modifier None Typical Low $66.07 Median $117.49 Typical High $213.80 | Facility | None | $66.07 | $117.49 | $213.80 |
Well Sense Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $112.20 | Professional | None | $83.18 | $85.11 | $112.20 |
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 $58.88 Median $60.26 Typical High $162.18 | Professional | 52 · Reduced service | $58.88 | $60.26 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.99 Typical High $64.57 | Professional | 53 · Discontinued | $23.44 | $23.99 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $89.13 Typical High $239.88 | Professional | 54 · Surgery only | $87.10 | $89.13 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.78 Typical High $48.98 | Professional | 55 · Aftercare only | $17.38 | $17.78 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.02 Typical High $32.36 | Professional | 56 · Pre-op care only | $11.75 | $12.02 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $83.18 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $81.28 | $83.18 | $223.87 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $177.83 Typical High $245.47 | Professional | 54 · Surgery only | $107.15 | $177.83 | $245.47 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $53.70 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $53.70 | $53.70 | $79.43 |
Where Massachusetts sits
The same service costs 5.1 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· 11th of 51
$209
AK $501UT $97.72
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.