How much rates vary
Facilitymedian $275 · 10th to 90th $107 to $2,042Professionalmedian $427 · 10th to 90th $204 to $1,096
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 $263.03 Median $2,691.53 Typical High $5,128.61 | Facility | None | $263.03 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $446.68 | Professional | None | $162.18 | $263.03 | $446.68 |
AllWays Health Partners Setting Facility Modifier None Typical Low $97.72 Median $478.63 Typical High $1,862.09 | Facility | None | $97.72 | $478.63 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $194.98 Median $457.09 Typical High $2,511.89 | Professional | None | $194.98 | $457.09 | $2,511.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $194.98 Median $234.42 Typical High $436.52 | Facility | None | $194.98 | $234.42 | $436.52 |
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 $239.88 Median $426.58 Typical High $707.95 | Professional | None | $239.88 | $426.58 | $707.95 |
Fallon Health Setting Facility Modifier None Typical Low $173.78 Median $239.88 Typical High $3,311.31 | Facility | None | $173.78 | $239.88 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $588.84 | Professional | None | $446.68 | $512.86 | $588.84 |
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 $208.93 Median $446.68 Typical High $933.25 | Professional | None | $208.93 | $446.68 | $933.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $97.72 Median $478.63 Typical High $1,862.09 | Facility | None | $97.72 | $478.63 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $194.98 Median $457.09 Typical High $2,511.89 | Professional | None | $194.98 | $457.09 | $2,511.89 |
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 $208.93 Median $371.54 Typical High $891.25 | Professional | None | $208.93 | $371.54 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $204.17 Typical High $346.74 | Facility | None | $97.72 | $204.17 | $346.74 |
Well Sense Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $204.17 | Professional | None | $112.20 | $151.36 | $204.17 |
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 $81.28 Median $131.83 Typical High $223.87 | Professional | 52 · Reduced service | $81.28 | $131.83 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $52.48 Typical High $91.20 | Professional | 53 · Discontinued | $32.36 | $52.48 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $199.53 Typical High $338.84 | Professional | 54 · Surgery only | $120.23 | $199.53 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $39.81 Typical High $67.61 | Professional | 55 · Aftercare only | $24.55 | $39.81 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $26.30 Typical High $44.67 | Professional | 56 · Pre-op care only | $16.22 | $26.30 | $44.67 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $107.15 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $72.44 | $107.15 | $147.91 |
Where Massachusetts sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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
$427
AK $741KY $186
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.