How much rates vary
Facilitymedian $251 · 10th to 90th $115 to $2,239Professionalmedian $245 · 10th to 90th $145 to $589
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 $436.52 Median $2,187.76 Typical High $3,630.78 | Facility | None | $436.52 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $389.05 | Professional | None | $123.03 | $147.91 | $389.05 |
AllWays Health Partners Setting Facility Modifier None Typical Low $97.72 Median $338.84 Typical High $1,862.09 | Facility | None | $97.72 | $338.84 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $1,174.90 | Professional | None | $147.91 | $275.42 | $1,174.90 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $309.03 | Facility | None | $138.04 | $165.96 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $331.13 Typical High $489.78 | Facility | None | $229.09 | $331.13 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $371.54 | Professional | None | $169.82 | $204.17 | $371.54 |
Fallon Health Setting Facility Modifier None Typical Low $134.90 Median $177.83 Typical High $3,311.31 | Facility | None | $134.90 | $177.83 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $269.15 | Professional | None | $199.53 | $229.09 | $269.15 |
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 $147.91 Median $295.12 Typical High $478.63 | Professional | None | $147.91 | $295.12 | $478.63 |
Mass General Brigham Setting Facility Modifier None Typical Low $97.72 Median $338.84 Typical High $1,862.09 | Facility | None | $97.72 | $338.84 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $1,174.90 | Professional | None | $147.91 | $275.42 | $1,174.90 |
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 $158.49 Median $223.87 Typical High $588.84 | Professional | None | $158.49 | $223.87 | $588.84 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $141.25 Typical High $223.87 | Facility | None | $97.72 | $141.25 | $223.87 |
Well Sense Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $131.83 | Professional | None | $97.72 | $109.65 | $131.83 |
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 $61.66 Median $74.13 Typical High $194.98 | Professional | 52 · Reduced service | $61.66 | $74.13 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $77.62 | Professional | 53 · Discontinued | $24.55 | $29.51 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $109.65 Typical High $295.12 | Professional | 54 · Surgery only | $91.20 | $109.65 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.88 Typical High $58.88 | Professional | 55 · Aftercare only | $18.62 | $21.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $38.90 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $102.33 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $87.10 | $102.33 | $275.42 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $162.18 Typical High $562.34 | Professional | 54 · Surgery only | $134.90 | $162.18 | $562.34 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $70.79 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $61.66 | $70.79 | $95.50 |
Where Massachusetts sits
The same service costs 3.8 times more in Alaska than in Delaware. 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
$245
AK $513DE $135
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.