How much rates vary
Facilitymedian $209 · 10th to 90th $98 to $2,188Professionalmedian $331 · 10th to 90th $135 to $1,950
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $186.21 Typical High $331.13 | Professional | None | $93.33 | $186.21 | $331.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $87.10 Median $309.03 Typical High $1,862.09 | Facility | None | $87.10 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $138.04 Median $363.08 Typical High $1,949.84 | Professional | None | $138.04 | $363.08 | $1,949.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $295.12 | Facility | None | $125.89 | $125.89 | $295.12 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $537.03 | Professional | None | $218.78 | $218.78 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $173.78 Typical High $251.19 | Facility | None | $53.70 | $173.78 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $354.81 Typical High $707.95 | Professional | None | $158.49 | $354.81 | $707.95 |
Fallon Health Setting Facility Modifier None Typical Low $114.82 Median $158.49 Typical High $3,311.31 | Facility | None | $114.82 | $158.49 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $489.78 | Professional | None | $323.59 | $389.05 | $489.78 |
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 $134.90 Median $316.23 Typical High $741.31 | Professional | None | $134.90 | $316.23 | $741.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $87.10 Median $309.03 Typical High $1,862.09 | Facility | None | $87.10 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $138.04 Median $363.08 Typical High $1,949.84 | Professional | None | $138.04 | $363.08 | $1,949.84 |
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 $147.91 Median $331.13 Typical High $812.83 | Professional | None | $147.91 | $331.13 | $812.83 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $151.36 Typical High $323.59 | Facility | None | $87.10 | $151.36 | $323.59 |
Well Sense Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $204.17 | Professional | None | $85.11 | $102.33 | $204.17 |
6 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 $46.77 Median $93.33 Typical High $165.96 | Professional | 52 · Reduced service | $46.77 | $93.33 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $37.15 Typical High $66.07 | Professional | 53 · Discontinued | $18.62 | $37.15 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $141.25 Typical High $251.19 | Professional | 54 · Surgery only | $69.18 | $141.25 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $28.18 Typical High $50.12 | Professional | 55 · Aftercare only | $13.80 | $28.18 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $18.62 Typical High $33.11 | Professional | 56 · Pre-op care only | $9.33 | $18.62 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $131.83 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $64.57 | $131.83 | $234.42 |
Where Massachusetts sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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
$316
WI $490KY $135
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.