How much rates vary
Facilitymedian $288 · 10th to 90th $120 to $3,311Professionalmedian $282 · 10th to 90th $138 to $1,549
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 $223.87 Median $2,691.53 Typical High $5,128.61 | Facility | None | $223.87 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $269.15 | Professional | None | $138.04 | $223.87 | $269.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $218.78 Median $616.60 Typical High $3,548.13 | Facility | None | $218.78 | $616.60 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $141.25 Median $338.84 Typical High $1,548.82 | Professional | None | $141.25 | $338.84 | $1,548.82 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $134.90 Median $162.18 Typical High $309.03 | Facility | None | $134.90 | $162.18 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $199.53 Typical High $199.53 | Facility | None | $50.12 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $537.03 | Professional | None | $154.88 | $263.03 | $537.03 |
Fallon Health Setting Facility Modifier None Typical Low $120.23 Median $169.82 Typical High $3,311.31 | Facility | None | $120.23 | $169.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $389.05 | Professional | None | $257.04 | $316.23 | $389.05 |
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 $141.25 Median $302.00 Typical High $616.60 | Professional | None | $141.25 | $302.00 | $616.60 |
Mass General Brigham Setting Facility Modifier None Typical Low $218.78 Median $616.60 Typical High $3,548.13 | Facility | None | $218.78 | $616.60 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $141.25 Median $338.84 Typical High $1,548.82 | Professional | None | $141.25 | $338.84 | $1,548.82 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,348.96 Typical High $5,128.61 | Facility | None | $575.44 | $1,348.96 | $5,128.61 |
United Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $691.83 | Professional | None | $158.49 | $281.84 | $691.83 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $151.36 Typical High $239.88 | Facility | None | $87.10 | $151.36 | $239.88 |
Well Sense Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $186.21 | Professional | None | $95.50 | $114.82 | $186.21 |
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 $69.18 Median $112.20 Typical High $186.21 | Professional | 52 · Reduced service | $69.18 | $112.20 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $45.71 Typical High $74.13 | Professional | 53 · Discontinued | $27.54 | $45.71 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $169.82 Typical High $275.42 | Professional | 54 · Surgery only | $102.33 | $169.82 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $33.88 Typical High $56.23 | Professional | 55 · Aftercare only | $20.42 | $33.88 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $22.39 Typical High $37.15 | Professional | 56 · Pre-op care only | $13.80 | $22.39 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $158.49 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $95.50 | $158.49 | $257.04 |
Where Massachusetts sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 12th of 51
$282
WI $589HI $155
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.