How much rates vary
Facilitymedian $245 · 10th to 90th $117 to $2,188Professionalmedian $363 · 10th to 90th $182 to $912
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $446.68 | Professional | None | $147.91 | $239.88 | $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 $407.38 Typical High $2,089.30 | Professional | None | $186.21 | $407.38 | $2,089.30 |
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 $354.81 Typical High $602.56 | Professional | None | $213.80 | $354.81 | $602.56 |
Fallon Health Setting Facility Modifier None Typical Low $154.88 Median $218.78 Typical High $3,311.31 | Facility | None | $154.88 | $218.78 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $501.19 | Professional | None | $371.54 | $426.58 | $501.19 |
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 $794.33 | Professional | None | $190.55 | $398.11 | $794.33 |
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 $407.38 Typical High $2,089.30 | Professional | None | $186.21 | $407.38 | $2,089.30 |
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 $323.59 Typical High $741.31 | Professional | None | $204.17 | $323.59 | $741.31 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $186.21 Typical High $288.40 | Facility | None | $97.72 | $186.21 | $288.40 |
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 $74.13 Median $117.49 Typical High $223.87 | Professional | 52 · Reduced service | $74.13 | $117.49 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $47.86 Typical High $89.13 | Professional | 53 · Discontinued | $29.51 | $47.86 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $177.83 Typical High $331.13 | Professional | 54 · Surgery only | $112.20 | $177.83 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $35.48 Typical High $67.61 | Professional | 55 · Aftercare only | $22.39 | $35.48 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $23.99 Typical High $44.67 | Professional | 56 · Pre-op care only | $14.79 | $23.99 | $44.67 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $107.15 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $72.44 | $107.15 | $144.54 |
Where Massachusetts sits
The same service costs 3.9 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· 8th of 51
$355
AK $692MD $178
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.