How much rates vary
Facilitymedian $339 · 10th to 90th $135 to $3,631Professionalmedian $302 · 10th to 90th $138 to $1,622
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 $218.78 Median $2,137.96 Typical High $3,388.44 | Facility | None | $218.78 | $2,137.96 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $363.08 | Professional | None | $134.90 | $218.78 | $363.08 |
AllWays Health Partners Setting Facility Modifier None Typical Low $295.12 Median $1,318.26 Typical High $5,011.87 | Facility | None | $295.12 | $1,318.26 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $144.54 Median $346.74 Typical High $1,621.81 | Professional | None | $144.54 | $346.74 | $1,621.81 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $309.03 | Facility | None | $134.90 | $134.90 | $309.03 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $446.68 | Professional | None | $229.09 | $229.09 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $831.76 | Facility | None | $199.53 | $316.23 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $588.84 | Professional | None | $162.18 | $288.40 | $588.84 |
Fallon Health Setting Facility Modifier None Typical Low $120.23 Median $165.96 Typical High $3,311.31 | Facility | None | $120.23 | $165.96 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $398.11 | Professional | None | $269.15 | $323.59 | $398.11 |
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 $138.04 Median $302.00 Typical High $676.08 | Professional | None | $138.04 | $302.00 | $676.08 |
Health New England Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Mass General Brigham Setting Facility Modifier None Typical Low $295.12 Median $1,318.26 Typical High $5,011.87 | Facility | None | $295.12 | $1,318.26 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $144.54 Median $346.74 Typical High $1,621.81 | Professional | None | $144.54 | $346.74 | $1,621.81 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $8,709.64 | Facility | None | $575.44 | $1,380.38 | $8,709.64 |
United Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $794.33 | Professional | None | $162.18 | $302.00 | $794.33 |
Well Sense Setting Facility Modifier None Typical Low $112.20 Median $165.96 Typical High $269.15 | Facility | None | $112.20 | $165.96 | $269.15 |
Well Sense Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $177.83 | Professional | None | $93.33 | $112.20 | $177.83 |
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 $66.07 Median $109.65 Typical High $181.97 | Professional | 52 · Reduced service | $66.07 | $109.65 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $43.65 Typical High $72.44 | Professional | 53 · Discontinued | $26.92 | $43.65 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $165.96 Typical High $275.42 | Professional | 54 · Surgery only | $100.00 | $165.96 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $33.11 Typical High $54.95 | Professional | 55 · Aftercare only | $19.95 | $33.11 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $21.88 Typical High $36.31 | Professional | 56 · Pre-op care only | $13.49 | $21.88 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $154.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $93.33 | $154.88 | $257.04 |
Where Massachusetts sits
The same service costs 3.8 times more in Wisconsin 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· 12th of 51
$302
WI $631KY $166
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.