How much rates vary
Facilitymedian $200 · 10th to 90th $100 to $2,239Professionalmedian $257 · 10th to 90th $123 to $1,413
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 $524.81 Median $2,187.76 Typical High $3,630.78 | Facility | None | $524.81 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $302.00 | Professional | None | $83.18 | $151.36 | $302.00 |
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 $125.89 Median $302.00 Typical High $1,412.54 | Professional | None | $125.89 | $302.00 | $1,412.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $275.42 | Facility | None | $117.49 | $117.49 | $275.42 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $389.05 | Professional | None | $204.17 | $204.17 | $389.05 |
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 $144.54 Median $245.47 Typical High $524.81 | Professional | None | $144.54 | $245.47 | $524.81 |
Fallon Health Setting Facility Modifier None Typical Low $114.82 Median $154.88 Typical High $3,311.31 | Facility | None | $114.82 | $154.88 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $346.74 | Professional | None | $234.42 | $281.84 | $346.74 |
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 $123.03 Median $269.15 Typical High $537.03 | Professional | None | $123.03 | $269.15 | $537.03 |
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 $125.89 Median $302.00 Typical High $1,412.54 | Professional | None | $125.89 | $302.00 | $1,412.54 |
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 $128.82 Median $251.19 Typical High $575.44 | Professional | None | $128.82 | $251.19 | $575.44 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $138.04 Typical High $218.78 | Facility | None | $87.10 | $138.04 | $218.78 |
Well Sense Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $158.49 | Professional | None | $75.86 | $91.20 | $158.49 |
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 $41.69 Median $74.13 Typical High $151.36 | Professional | 52 · Reduced service | $41.69 | $74.13 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $30.20 Typical High $60.26 | Professional | 53 · Discontinued | $16.98 | $30.20 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $112.20 Typical High $223.87 | Professional | 54 · Surgery only | $63.10 | $112.20 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $22.39 Typical High $44.67 | Professional | 55 · Aftercare only | $12.59 | $22.39 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $15.14 Typical High $30.20 | Professional | 56 · Pre-op care only | $8.32 | $15.14 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $104.71 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $58.88 | $104.71 | $208.93 |
Where Massachusetts sits
The same service costs 4.5 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
$257
AK $457KY $102
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.