How much rates vary
Facilitymedian $269 · 10th to 90th $110 to $1,995Professionalmedian $427 · 10th to 90th $195 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 $213.80 Median $2,691.53 Typical High $5,128.61 | Facility | None | $213.80 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $436.52 | Professional | None | $131.83 | $213.80 | $436.52 |
AllWays Health Partners Setting Facility Modifier None Typical Low $97.72 Median $331.13 Typical High $1,819.70 | Facility | None | $97.72 | $331.13 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $186.21 Median $446.68 Typical High $2,511.89 | Professional | None | $186.21 | $446.68 | $2,511.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $426.58 | Facility | None | $190.55 | $229.09 | $426.58 |
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 $234.42 Median $426.58 Typical High $707.95 | Professional | None | $234.42 | $426.58 | $707.95 |
Fallon Health Setting Facility Modifier None Typical Low $165.96 Median $234.42 Typical High $3,311.31 | Facility | None | $165.96 | $234.42 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $602.56 | Professional | None | $446.68 | $512.86 | $602.56 |
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 $199.53 Median $436.52 Typical High $954.99 | Professional | None | $199.53 | $436.52 | $954.99 |
Mass General Brigham Setting Facility Modifier None Typical Low $97.72 Median $331.13 Typical High $1,819.70 | Facility | None | $97.72 | $331.13 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $186.21 Median $446.68 Typical High $2,511.89 | Professional | None | $186.21 | $446.68 | $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 $194.98 Median $363.08 Typical High $891.25 | Professional | None | $194.98 | $363.08 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $194.98 Typical High $346.74 | Facility | None | $97.72 | $194.98 | $346.74 |
Well Sense Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $199.53 | Professional | None | $112.20 | $151.36 | $199.53 |
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 $66.07 Median $107.15 Typical High $218.78 | Professional | 52 · Reduced service | $66.07 | $107.15 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $42.66 Typical High $87.10 | Professional | 53 · Discontinued | $26.30 | $42.66 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $158.49 Typical High $331.13 | Professional | 54 · Surgery only | $100.00 | $158.49 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $31.62 Typical High $66.07 | Professional | 55 · Aftercare only | $19.95 | $31.62 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.38 Typical High $43.65 | Professional | 56 · Pre-op care only | $13.18 | $21.38 | $43.65 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $107.15 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $70.79 | $107.15 | $144.54 |
Where Massachusetts sits
The same service costs 4.0 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
$417
AK $724MD $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.