How much rates vary
Facilitymedian $269 · 10th to 90th $100 to $3,311Professionalmedian $224 · 10th to 90th $115 to $1,148
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 $123.03 Median $2,691.53 Typical High $5,128.61 | Facility | None | $123.03 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $281.84 | Professional | None | $79.43 | $123.03 | $281.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $251.19 Median $1,071.52 Typical High $3,630.78 | Facility | None | $251.19 | $1,071.52 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $117.49 Median $269.15 Typical High $1,148.15 | Professional | None | $117.49 | $269.15 | $1,148.15 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $257.04 | Facility | None | $112.20 | $112.20 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $213.80 Typical High $489.78 | Facility | None | $100.00 | $213.80 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $436.52 | Professional | None | $134.90 | $199.53 | $436.52 |
Fallon Health Setting Facility Modifier None Typical Low $109.65 Median $144.54 Typical High $3,311.31 | Facility | None | $109.65 | $144.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $288.40 | Professional | None | $190.55 | $234.42 | $288.40 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $117.49 Median $245.47 Typical High $467.74 | Professional | None | $117.49 | $245.47 | $467.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $251.19 Median $1,071.52 Typical High $3,630.78 | Facility | None | $251.19 | $1,071.52 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $117.49 Median $269.15 Typical High $1,148.15 | Professional | None | $117.49 | $269.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,165.95 | Facility | None | $575.44 | $1,380.38 | $6,165.95 |
United Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $467.74 | Professional | None | $117.49 | $208.93 | $467.74 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $186.21 | Facility | None | $87.10 | $120.23 | $186.21 |
Well Sense Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $128.82 | Professional | None | $72.44 | $87.10 | $128.82 |
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 $38.90 Median $60.26 Typical High $141.25 | Professional | 52 · Reduced service | $38.90 | $60.26 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $24.55 Typical High $56.23 | Professional | 53 · Discontinued | $15.85 | $24.55 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $91.20 Typical High $213.80 | Professional | 54 · Surgery only | $58.88 | $91.20 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $18.20 Typical High $42.66 | Professional | 55 · Aftercare only | $11.75 | $18.20 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.30 Typical High $28.18 | Professional | 56 · Pre-op care only | $7.94 | $12.30 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $85.11 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $54.95 | $85.11 | $199.53 |
Where Massachusetts sits
The same service costs 4.4 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
$229
AK $417KY $95.50
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.