How much rates vary
Facilitymedian $132 · 10th to 90th $66 to $1,820Professionalmedian $158 · 10th to 90th $81 to $398
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 $66.07 Median $89.13 Typical High $281.84 | Facility | None | $66.07 | $89.13 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $218.78 | Professional | None | $66.07 | $89.13 | $218.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $52.48 Median $309.03 Typical High $1,862.09 | Facility | None | $52.48 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $870.96 | Professional | None | $81.28 | $177.83 | $870.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $173.78 | Facility | None | $74.13 | $74.13 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $128.82 Typical High $199.53 | Facility | None | $53.70 | $128.82 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $257.04 | Professional | None | $100.00 | $144.54 | $257.04 |
Fallon Health Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $3,311.31 | Facility | None | $74.13 | $93.33 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $204.17 | Professional | None | $151.36 | $173.78 | $204.17 |
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 $87.10 Median $173.78 Typical High $338.84 | Professional | None | $87.10 | $173.78 | $338.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $52.48 Median $309.03 Typical High $1,862.09 | Facility | None | $52.48 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $870.96 | Professional | None | $81.28 | $177.83 | $870.96 |
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 $95.50 Median $144.54 Typical High $346.74 | Professional | None | $95.50 | $144.54 | $346.74 |
Well Sense Setting Facility Modifier None Typical Low $46.77 Median $85.11 Typical High $131.83 | Facility | None | $46.77 | $85.11 | $131.83 |
Well Sense Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $87.10 | Professional | None | $54.95 | $72.44 | $87.10 |
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 $33.11 Median $44.67 Typical High $107.15 | Professional | 52 · Reduced service | $33.11 | $44.67 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $17.78 Typical High $43.65 | Professional | 53 · Discontinued | $13.18 | $17.78 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.18 Typical High $32.36 | Professional | 55 · Aftercare only | $10.00 | $13.18 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.91 Typical High $21.88 | Professional | 56 · Pre-op care only | $6.61 | $8.91 | $21.88 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $35.48 Median $46.77 Typical High $63.10 | Professional | 78 · Unplanned return to OR | $35.48 | $46.77 | $63.10 |
Where Massachusetts sits
The same service costs 3.8 times more in Alaska than in Florida. 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
$155
AK $309FL $81.28
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.