How much rates vary
Facilitymedian $151 · 10th to 90th $72 to $1,820Professionalmedian $186 · 10th to 90th $100 to $457
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 $81.28 Median $123.03 Typical High $338.84 | Facility | None | $81.28 | $123.03 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $251.19 | Professional | None | $81.28 | $117.49 | $251.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $63.10 Median $309.03 Typical High $1,862.09 | Facility | None | $63.10 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $100.00 Median $218.78 Typical High $1,023.29 | Professional | None | $100.00 | $218.78 | $1,023.29 |
BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $213.80 | Facility | None | $93.33 | $93.33 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $173.78 Typical High $199.53 | Facility | None | $53.70 | $173.78 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $302.00 | Professional | None | $117.49 | $173.78 | $302.00 |
Fallon Health Setting Facility Modifier None Typical Low $87.10 Median $117.49 Typical High $3,311.31 | Facility | None | $87.10 | $117.49 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $239.88 | Professional | None | $181.97 | $208.93 | $239.88 |
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 $104.71 Median $208.93 Typical High $398.11 | Professional | None | $104.71 | $208.93 | $398.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $63.10 Median $309.03 Typical High $1,862.09 | Facility | None | $63.10 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $100.00 Median $218.78 Typical High $1,023.29 | Professional | None | $100.00 | $218.78 | $1,023.29 |
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 $107.15 Median $169.82 Typical High $398.11 | Professional | None | $107.15 | $169.82 | $398.11 |
Well Sense Setting Facility Modifier None Typical Low $63.10 Median $97.72 Typical High $151.36 | Facility | None | $63.10 | $97.72 | $151.36 |
Well Sense Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $102.33 | Professional | None | $63.10 | $85.11 | $102.33 |
5 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 $40.74 Median $58.88 Typical High $125.89 | Professional | 52 · Reduced service | $40.74 | $58.88 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $23.44 Typical High $50.12 | Professional | 53 · Discontinued | $16.22 | $23.44 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.38 Typical High $37.15 | Professional | 55 · Aftercare only | $12.30 | $17.38 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $11.75 Typical High $25.12 | Professional | 56 · Pre-op care only | $8.13 | $11.75 | $25.12 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $39.81 Median $54.95 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $39.81 | $54.95 | $74.13 |
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· 9th of 51
$186
AK $355MD $97.72
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.