How much rates vary
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 $2,691.53 Median $3,090.30 Typical High $5,623.41 | Facility | None | $2,691.53 | $3,090.30 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $3,235.94 | Professional | None | $1,288.25 | $1,288.25 | $3,235.94 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,570.88 | Facility | None | $346.74 | $1,047.13 | $4,570.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,905.46 Median $4,677.35 Typical High $22,908.68 | Professional | None | $1,905.46 | $4,677.35 | $22,908.68 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $1,380.38 | Facility | None | $50.12 | $954.99 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $5,248.07 | Professional | None | $2,951.21 | $2,951.21 | $5,248.07 |
Fallon Health Setting Facility Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $3,467.37 | Facility | None | $1,995.26 | $2,454.71 | $3,467.37 |
Fallon Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,454.71 | $2,951.21 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,187.76 Median $3,981.07 Typical High $6,025.60 | Professional | None | $2,187.76 | $3,981.07 | $6,025.60 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,570.88 | Facility | None | $346.74 | $1,047.13 | $4,570.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,905.46 Median $4,677.35 Typical High $22,908.68 | Professional | None | $1,905.46 | $4,677.35 | $22,908.68 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $3,090.30 Typical High $8,511.38 | Professional | None | $2,238.72 | $3,090.30 | $8,511.38 |
Well Sense Setting Facility Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $2,884.03 | Facility | None | $1,412.54 | $1,905.46 | $2,884.03 |
Well Sense Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,479.11 | $1,778.28 |
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 $645.65 Median $645.65 Typical High $2,884.03 | Professional | 52 · Reduced service | $645.65 | $645.65 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $1,148.15 | Professional | 53 · Discontinued | $257.04 | $257.04 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $4,265.80 | Professional | 54 · Surgery only | $954.99 | $954.99 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $870.96 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $575.44 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $3,981.07 |
Where Massachusetts sits
The same service costs 6.0 times more in Alaska than in Texas. 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· 21st of 51
$2,818
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.