How much rates vary
Facilitymedian $1,175 · 10th to 90th $603 to $5,248Professionalmedian $1,000 · 10th to 90th $603 to $4,365
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 $1,584.89 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,584.89 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,584.89 | Professional | None | $575.44 | $575.44 | $1,584.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $5,248.07 | Facility | None | $602.56 | $1,621.81 | $5,248.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $602.56 Median $1,513.56 Typical High $4,365.16 | Professional | None | $602.56 | $1,513.56 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,698.24 | Facility | None | $831.76 | $1,202.26 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,659.59 | Professional | None | $851.14 | $851.14 | $1,659.59 |
Fallon Health Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $3,311.31 | Facility | None | $660.69 | $851.14 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,000.00 | Professional | None | $741.31 | $870.96 | $1,000.00 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $3,019.95 Typical High $7,762.47 | Facility | None | $741.31 | $3,019.95 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $724.44 Median $1,318.26 Typical High $1,995.26 | Professional | None | $724.44 | $1,318.26 | $1,995.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $5,248.07 | Facility | None | $602.56 | $1,621.81 | $5,248.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $602.56 Median $1,513.56 Typical High $4,365.16 | Professional | None | $602.56 | $1,513.56 | $4,365.16 |
United Setting Facility Modifier None Typical Low $851.14 Median $3,090.30 Typical High $7,244.36 | Facility | None | $851.14 | $3,090.30 | $7,244.36 |
United Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $2,818.38 | Professional | None | $645.65 | $933.25 | $2,818.38 |
Well Sense Setting Facility Modifier None Typical Low $501.19 Median $645.65 Typical High $977.24 | Facility | None | $501.19 | $645.65 | $977.24 |
Well Sense Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $562.34 | Professional | None | $416.87 | $416.87 | $562.34 |
7 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 $288.40 Median $288.40 Typical High $794.33 | Professional | 52 · Reduced service | $288.40 | $288.40 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $316.23 | Professional | 53 · Discontinued | $114.82 | $114.82 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $1,202.26 | Professional | 54 · Surgery only | $436.52 | $436.52 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $239.88 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $158.49 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $1,122.02 |
BCBS Massachusetts Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $128.82 Typical High $208.93 | Professional | AS · PA/NP assist | $104.71 | $128.82 | $208.93 |
Where Massachusetts sits
The same service costs 7.2 times more in Alaska than in Utah. 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· 18th of 51
$1,000
AK $2,570UT $355
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.