How much rates vary
Facilitymedian $1,148 · 10th to 90th $355 to $5,248Professionalmedian $1,778 · 10th to 90th $380 to $6,918
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 $1,023.29 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,023.29 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $870.96 Typical High $1,258.93 | Professional | None | $208.93 | $870.96 | $1,258.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $524.81 Median $1,949.84 Typical High $5,623.41 | Facility | None | $524.81 | $1,949.84 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $371.54 Median $1,862.09 Typical High $11,748.98 | Professional | None | $371.54 | $1,862.09 | $11,748.98 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $354.81 Median $426.58 Typical High $812.83 | Facility | None | $354.81 | $426.58 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,511.89 Typical High $3,162.28 | Facility | None | $676.08 | $2,511.89 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $1,479.11 Typical High $3,715.35 | Professional | None | $524.81 | $1,479.11 | $3,715.35 |
Fallon Health Setting Facility Modifier None Typical Low $354.81 Median $457.09 Typical High $3,311.31 | Facility | None | $354.81 | $457.09 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,344.23 | $2,884.03 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $389.05 Median $1,659.59 Typical High $4,466.84 | Professional | None | $389.05 | $1,659.59 | $4,466.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $524.81 Median $1,949.84 Typical High $5,623.41 | Facility | None | $524.81 | $1,949.84 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $371.54 Median $1,862.09 Typical High $11,748.98 | Professional | None | $371.54 | $1,862.09 | $11,748.98 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $446.68 Median $1,548.82 Typical High $5,248.07 | Professional | None | $446.68 | $1,548.82 | $5,248.07 |
Well Sense Setting Facility Modifier None Typical Low $295.12 Median $1,071.52 Typical High $1,819.70 | Facility | None | $295.12 | $1,071.52 | $1,819.70 |
Well Sense Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $891.25 | Professional | None | $229.09 | $275.42 | $891.25 |
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 $104.71 Median $436.52 Typical High $616.60 | Professional | 52 · Reduced service | $104.71 | $436.52 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $173.78 Typical High $251.19 | Professional | 53 · Discontinued | $41.69 | $173.78 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $645.65 Typical High $933.25 | Professional | 54 · Surgery only | $158.49 | $645.65 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $128.82 Typical High $186.21 | Professional | 55 · Aftercare only | $31.62 | $128.82 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $87.10 Typical High $125.89 | Professional | 56 · Pre-op care only | $20.89 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $602.56 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $147.91 | $602.56 | $870.96 |
Where Massachusetts sits
The same service costs 5.8 times more in Alaska than in Nebraska. 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· 19th of 51
$1,622
AK $3,548NE $617
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.