How much rates vary
Facilitymedian $251 · 10th to 90th $110 to $1,862Professionalmedian $398 · 10th to 90th $186 to $1,023
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 $208.93 Median $2,691.53 Typical High $5,128.61 | Facility | None | $208.93 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $446.68 | Professional | None | $128.82 | $208.93 | $446.68 |
AllWays Health Partners Setting Facility Modifier None Typical Low $97.72 Median $426.58 Typical High $1,862.09 | Facility | None | $97.72 | $426.58 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $186.21 Median $416.87 Typical High $2,344.23 | Professional | None | $186.21 | $416.87 | $2,344.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $407.38 | Facility | None | $173.78 | $173.78 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $204.17 Typical High $295.12 | Facility | None | $53.70 | $204.17 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $660.69 | Professional | None | $213.80 | $398.11 | $660.69 |
Fallon Health Setting Facility Modifier None Typical Low $158.49 Median $218.78 Typical High $3,311.31 | Facility | None | $158.49 | $218.78 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $562.34 | Professional | None | $416.87 | $478.63 | $562.34 |
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 $190.55 Median $398.11 Typical High $891.25 | Professional | None | $190.55 | $398.11 | $891.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $97.72 Median $426.58 Typical High $1,862.09 | Facility | None | $97.72 | $426.58 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $186.21 Median $416.87 Typical High $2,344.23 | Professional | None | $186.21 | $416.87 | $2,344.23 |
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 $204.17 Median $363.08 Typical High $831.76 | Professional | None | $204.17 | $363.08 | $831.76 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $190.55 Typical High $323.59 | Facility | None | $97.72 | $190.55 | $323.59 |
Well Sense Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $190.55 | Professional | None | $102.33 | $138.04 | $190.55 |
6 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 $64.57 Median $104.71 Typical High $223.87 | Professional | 52 · Reduced service | $64.57 | $104.71 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $41.69 Typical High $89.13 | Professional | 53 · Discontinued | $25.70 | $41.69 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $154.88 Typical High $331.13 | Professional | 54 · Surgery only | $95.50 | $154.88 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $31.62 Typical High $67.61 | Professional | 55 · Aftercare only | $19.05 | $31.62 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.89 Typical High $44.67 | Professional | 56 · Pre-op care only | $12.88 | $20.89 | $44.67 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $97.72 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $66.07 | $97.72 | $138.04 |
Where Massachusetts sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 7th of 51
$389
AK $661MD $182
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.