How much rates vary
Facilitymedian $135 · 10th to 90th $59 to $2,042Professionalmedian $155 · 10th to 90th $68 to $380
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 $67.61 Median $2,691.53 Typical High $5,128.61 | Facility | None | $67.61 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $169.82 | Professional | None | $51.29 | $67.61 | $169.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $52.48 Median $309.03 Typical High $1,862.09 | Facility | None | $52.48 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $74.13 Median $177.83 Typical High $831.76 | Professional | None | $74.13 | $177.83 | $831.76 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $75.86 Median $93.33 Typical High $173.78 | Facility | None | $75.86 | $93.33 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $147.91 Typical High $199.53 | Facility | None | $53.70 | $147.91 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $245.47 | Professional | None | $93.33 | $141.25 | $245.47 |
Fallon Health Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $3,311.31 | Facility | None | $75.86 | $95.50 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $199.53 | Professional | None | $147.91 | $173.78 | $199.53 |
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 $81.28 Median $165.96 Typical High $316.23 | Professional | None | $81.28 | $165.96 | $316.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $52.48 Median $309.03 Typical High $1,862.09 | Facility | None | $52.48 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $74.13 Median $177.83 Typical High $831.76 | Professional | None | $74.13 | $177.83 | $831.76 |
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 $75.86 Median $134.90 Typical High $316.23 | Professional | None | $75.86 | $134.90 | $316.23 |
Well Sense Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $120.23 | Facility | None | $52.48 | $77.62 | $120.23 |
Well Sense Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $75.86 | Professional | None | $44.67 | $60.26 | $75.86 |
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 $25.70 Median $33.88 Typical High $85.11 | Professional | 52 · Reduced service | $25.70 | $33.88 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $13.49 Typical High $33.88 | Professional | 53 · Discontinued | $10.23 | $13.49 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $51.29 Typical High $128.82 | Professional | 54 · Surgery only | $38.90 | $51.29 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.23 Typical High $25.70 | Professional | 55 · Aftercare only | $7.76 | $10.23 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.76 Typical High $16.98 | Professional | 56 · Pre-op care only | $5.13 | $6.76 | $16.98 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.84 Median $39.81 Typical High $54.95 | Professional | 78 · Unplanned return to OR | $28.84 | $39.81 | $54.95 |
Where Massachusetts sits
The same service costs 3.8 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· 8th of 51
$155
AK $282FL $74.13
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.