How much rates vary
Facilitymedian $138 · 10th to 90th $66 to $1,820Professionalmedian $178 · 10th to 90th $93 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 $75.86 Median $117.49 Typical High $331.13 | Facility | None | $75.86 | $117.49 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $234.42 | Professional | None | $75.86 | $117.49 | $234.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $57.54 Median $309.03 Typical High $1,862.09 | Facility | None | $57.54 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $95.50 Median $194.98 Typical High $1,000.00 | Professional | None | $95.50 | $194.98 | $1,000.00 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $186.21 | Facility | None | $79.43 | $79.43 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $112.20 Typical High $162.18 | Facility | None | $53.70 | $112.20 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $295.12 | Professional | None | $107.15 | $169.82 | $295.12 |
Fallon Health Setting Facility Modifier None Typical Low $79.43 Median $104.71 Typical High $3,311.31 | Facility | None | $79.43 | $104.71 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $234.42 | Professional | None | $177.83 | $204.17 | $234.42 |
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 $97.72 Median $190.55 Typical High $380.19 | Professional | None | $97.72 | $190.55 | $380.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $57.54 Median $309.03 Typical High $1,862.09 | Facility | None | $57.54 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $95.50 Median $194.98 Typical High $1,000.00 | Professional | None | $95.50 | $194.98 | $1,000.00 |
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 $104.71 Median $165.96 Typical High $371.54 | Professional | None | $104.71 | $165.96 | $371.54 |
Well Sense Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $141.25 | Facility | None | $57.54 | $93.33 | $141.25 |
Well Sense Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $100.00 | Professional | None | $58.88 | $79.43 | $100.00 |
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 $38.02 Median $58.88 Typical High $114.82 | Professional | 52 · Reduced service | $38.02 | $58.88 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $23.44 Typical High $46.77 | Professional | 53 · Discontinued | $15.14 | $23.44 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $17.38 Typical High $34.67 | Professional | 55 · Aftercare only | $11.48 | $17.38 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $11.75 Typical High $23.44 | Professional | 56 · Pre-op care only | $7.59 | $11.75 | $23.44 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.02 Median $53.70 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $38.02 | $53.70 | $72.44 |
Where Massachusetts sits
The same service costs 3.5 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
$178
AK $339MD $95.50
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.