How much rates vary
Facilitymedian $170 · 10th to 90th $79 to $2,188Professionalmedian $186 · 10th to 90th $112 to $468
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 $316.23 Median $2,187.76 Typical High $3,630.78 | Facility | None | $316.23 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $295.12 | Professional | None | $97.72 | $112.20 | $295.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $63.10 Median $331.13 Typical High $1,862.09 | Facility | None | $63.10 | $331.13 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $117.49 Median $239.88 Typical High $933.25 | Professional | None | $117.49 | $239.88 | $933.25 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $275.42 | Facility | None | $120.23 | $120.23 | $275.42 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $251.19 | Professional | None | $120.23 | $147.91 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $112.20 Typical High $162.18 | Facility | None | $53.70 | $112.20 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $295.12 | Professional | None | $144.54 | $165.96 | $295.12 |
Fallon Health Setting Facility Modifier None Typical Low $109.65 Median $147.91 Typical High $3,311.31 | Facility | None | $109.65 | $147.91 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $218.78 | Professional | None | $162.18 | $186.21 | $218.78 |
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 $125.89 Median $245.47 Typical High $380.19 | Professional | None | $125.89 | $245.47 | $380.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $63.10 Median $331.13 Typical High $1,862.09 | Facility | None | $63.10 | $331.13 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $117.49 Median $239.88 Typical High $933.25 | Professional | None | $117.49 | $239.88 | $933.25 |
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 $123.03 Median $173.78 Typical High $467.74 | Professional | None | $123.03 | $173.78 | $467.74 |
Well Sense Setting Facility Modifier None Typical Low $63.10 Median $107.15 Typical High $181.97 | Facility | None | $63.10 | $107.15 | $181.97 |
Well Sense Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $100.00 | Professional | None | $74.13 | $81.28 | $100.00 |
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 $48.98 Median $56.23 Typical High $147.91 | Professional | 52 · Reduced service | $48.98 | $56.23 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.39 Typical High $58.88 | Professional | 53 · Discontinued | $19.50 | $22.39 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $83.18 Typical High $218.78 | Professional | 54 · Surgery only | $74.13 | $83.18 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.60 Typical High $43.65 | Professional | 55 · Aftercare only | $14.79 | $16.60 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.22 Typical High $29.51 | Professional | 56 · Pre-op care only | $9.77 | $11.22 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $77.62 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $69.18 | $77.62 | $204.17 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $51.29 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $46.77 | $51.29 | $70.79 |
Where Massachusetts sits
The same service costs 4.5 times more in Alaska than in Florida. 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
$186
AK $427FL $95.50
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.