How much rates vary
Facilitymedian $105 · 10th to 90th $43 to $1,820Professionalmedian $117 · 10th to 90th $48 to $324
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 $40.74 Median $81.28 Typical High $223.87 | Facility | None | $40.74 | $81.28 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $81.28 Typical High $125.89 | Professional | None | $40.74 | $81.28 | $125.89 |
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 $48.98 Median $117.49 Typical High $724.44 | Professional | None | $48.98 | $117.49 | $724.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $100.00 | Facility | None | $42.66 | $42.66 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $134.90 Typical High $199.53 | Facility | None | $53.70 | $134.90 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $123.03 Typical High $208.93 | Professional | None | $57.54 | $123.03 | $208.93 |
Fallon Health Setting Facility Modifier None Typical Low $42.66 Median $56.23 Typical High $3,311.31 | Facility | None | $42.66 | $56.23 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $173.78 | Professional | None | $128.82 | $147.91 | $173.78 |
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 $52.48 Median $117.49 Typical High $275.42 | Professional | None | $52.48 | $117.49 | $275.42 |
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 $48.98 Median $117.49 Typical High $724.44 | Professional | None | $48.98 | $117.49 | $724.44 |
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 $56.23 Median $109.65 Typical High $257.04 | Professional | None | $56.23 | $109.65 | $257.04 |
Well Sense Setting Facility Modifier None Typical Low $38.02 Median $57.54 Typical High $100.00 | Facility | None | $38.02 | $57.54 | $100.00 |
Well Sense Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $67.61 | Professional | None | $31.62 | $42.66 | $67.61 |
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 $20.42 Median $40.74 Typical High $63.10 | Professional | 52 · Reduced service | $20.42 | $40.74 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $16.60 Typical High $25.12 | Professional | 53 · Discontinued | $8.13 | $16.60 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $12.30 Typical High $18.62 | Professional | 55 · Aftercare only | $6.03 | $12.30 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $8.13 Typical High $12.59 | Professional | 56 · Pre-op care only | $4.07 | $8.13 | $12.59 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.95 Median $30.20 Typical High $48.98 | Professional | 78 · Unplanned return to OR | $19.95 | $30.20 | $48.98 |
Where Massachusetts sits
The same service costs 3.9 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· 9th of 51
$115
AK $204VA $52.48
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.