How much rates vary
Facilitymedian $372 · 10th to 90th $191 to $2,399Professionalmedian $437 · 10th to 90th $229 to $2,291
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 $691.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $691.83 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $630.96 | Professional | None | $229.09 | $331.13 | $630.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $190.55 Median $512.86 Typical High $2,041.74 | Facility | None | $190.55 | $512.86 | $2,041.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $223.87 Median $524.81 Typical High $2,290.87 | Professional | None | $223.87 | $524.81 | $2,290.87 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $218.78 Median $263.03 Typical High $501.19 | Facility | None | $218.78 | $263.03 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $549.54 Typical High $776.25 | Facility | None | $199.53 | $549.54 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $831.76 | Professional | None | $263.03 | $389.05 | $831.76 |
Fallon Health Setting Facility Modifier None Typical Low $213.80 Median $281.84 Typical High $3,311.31 | Facility | None | $213.80 | $281.84 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $562.34 | Professional | None | $380.19 | $457.09 | $562.34 |
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 $234.42 Median $478.63 Typical High $954.99 | Professional | None | $234.42 | $478.63 | $954.99 |
Mass General Brigham Setting Facility Modifier None Typical Low $190.55 Median $512.86 Typical High $2,041.74 | Facility | None | $190.55 | $512.86 | $2,041.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $223.87 Median $524.81 Typical High $2,290.87 | Professional | None | $223.87 | $524.81 | $2,290.87 |
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 $269.15 Median $426.58 Typical High $1,174.90 | Professional | None | $269.15 | $426.58 | $1,174.90 |
Well Sense Setting Facility Modifier None Typical Low $181.97 Median $245.47 Typical High $354.81 | Facility | None | $181.97 | $245.47 | $354.81 |
Well Sense Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $269.15 | Professional | None | $158.49 | $190.55 | $269.15 |
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 $114.82 Median $165.96 Typical High $316.23 | Professional | 52 · Reduced service | $114.82 | $165.96 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $66.07 Typical High $125.89 | Professional | 53 · Discontinued | $45.71 | $66.07 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $251.19 Typical High $467.74 | Professional | 54 · Surgery only | $173.78 | $251.19 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $50.12 Typical High $93.33 | Professional | 55 · Aftercare only | $34.67 | $50.12 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $33.11 Typical High $63.10 | Professional | 56 · Pre-op care only | $22.91 | $33.11 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $234.42 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $162.18 | $234.42 | $436.52 |
Where Massachusetts sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 11th of 51
$437
WI $891UT $240
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.