How much rates vary
Facilitymedian $263 · 10th to 90th $120 to $2,188Professionalmedian $339 · 10th to 90th $135 to $1,995
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 $190.55 Typical High $338.84 | Professional | None | $93.33 | $190.55 | $338.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $134.90 Median $524.81 Typical High $1,862.09 | Facility | None | $134.90 | $524.81 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $141.25 Median $363.08 Typical High $1,995.26 | Professional | None | $141.25 | $363.08 | $1,995.26 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $302.00 | Facility | None | $128.82 | $128.82 | $302.00 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $549.54 | Professional | None | $218.78 | $218.78 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $288.40 Typical High $416.87 | Facility | None | $53.70 | $288.40 | $416.87 |
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 $117.49 Median $162.18 Typical High $3,311.31 | Facility | None | $117.49 | $162.18 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $489.78 | Professional | None | $331.13 | $398.11 | $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 $323.59 Typical High $776.25 | Professional | None | $134.90 | $323.59 | $776.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $134.90 Median $524.81 Typical High $1,862.09 | Facility | None | $134.90 | $524.81 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $141.25 Median $363.08 Typical High $1,995.26 | Professional | None | $141.25 | $363.08 | $1,995.26 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $151.36 Median $323.59 Typical High $831.76 | Professional | None | $151.36 | $323.59 | $831.76 |
Well Sense Setting Facility Modifier None Typical Low $112.20 Median $186.21 Typical High $323.59 | Facility | None | $112.20 | $186.21 | $323.59 |
Well Sense Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $199.53 | Professional | None | $87.10 | $104.71 | $199.53 |
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 $95.50 Typical High $165.96 | Professional | 52 · Reduced service | $46.77 | $95.50 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $38.02 Typical High $67.61 | Professional | 53 · Discontinued | $18.62 | $38.02 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $141.25 Typical High $251.19 | Professional | 54 · Surgery only | $70.79 | $141.25 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $28.84 Typical High $50.12 | Professional | 55 · Aftercare only | $14.13 | $28.84 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $19.05 Typical High $33.88 | Professional | 56 · Pre-op care only | $9.33 | $19.05 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $131.83 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $66.07 | $131.83 | $234.42 |
Where Massachusetts sits
The same service costs 3.9 times more in Alaska 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
$324
AK $562KY $145
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.