How much rates vary
Facilitymedian $65 · 10th to 90th $26 to $1,820Professionalmedian $63 · 10th to 90th $34 to $155
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 $26.30 Median $41.69 Typical High $147.91 | Facility | None | $26.30 | $41.69 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $41.69 Typical High $97.72 | Professional | None | $26.30 | $41.69 | $97.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $257.04 Typical High $1,862.09 | Facility | None | $50.12 | $257.04 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $36.31 Median $69.18 Typical High $331.13 | Professional | None | $36.31 | $69.18 | $331.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $66.07 | Facility | None | $28.18 | $28.18 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $45.71 Typical High $199.53 | Facility | None | $32.36 | $45.71 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $58.88 Typical High $102.33 | Professional | None | $35.48 | $58.88 | $102.33 |
Fallon Health Setting Facility Modifier None Typical Low $28.84 Median $37.15 Typical High $3,311.31 | Facility | None | $28.84 | $37.15 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $75.86 | Professional | None | $56.23 | $66.07 | $75.86 |
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 $36.31 Median $67.61 Typical High $125.89 | Professional | None | $36.31 | $67.61 | $125.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $257.04 Typical High $1,862.09 | Facility | None | $50.12 | $257.04 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $36.31 Median $69.18 Typical High $331.13 | Professional | None | $36.31 | $69.18 | $331.13 |
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 $37.15 Median $60.26 Typical High $128.82 | Professional | None | $37.15 | $60.26 | $128.82 |
Well Sense Setting Facility Modifier None Typical Low $18.62 Median $32.36 Typical High $48.98 | Facility | None | $18.62 | $32.36 | $48.98 |
Well Sense Setting Professional Modifier None Typical Low $24.55 Median $33.11 Typical High $44.67 | Professional | None | $24.55 | $33.11 | $44.67 |
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 $13.18 Median $20.89 Typical High $48.98 | Professional | 52 · Reduced service | $13.18 | $20.89 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $8.32 Typical High $19.50 | Professional | 53 · Discontinued | $5.25 | $8.32 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $6.17 Typical High $14.45 | Professional | 55 · Aftercare only | $3.98 | $6.17 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $4.17 Typical High $9.77 | Professional | 56 · Pre-op care only | $2.63 | $4.17 | $9.77 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $15.85 Median $23.44 Typical High $32.36 | Professional | 78 · Unplanned return to OR | $15.85 | $23.44 | $32.36 |
Where Massachusetts sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 10th of 51
$63.10
AK $112VA $33.88
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.