How much rates vary
Facilitymedian $891 · 10th to 90th $302 to $4,266Professionalmedian $575 · 10th to 90th $316 to $2,818
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 $870.96 Median $2,691.53 Typical High $3,715.35 | Facility | None | $870.96 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $724.44 | Professional | None | $316.23 | $407.38 | $724.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $1,819.70 Typical High $5,128.61 | Facility | None | $457.09 | $1,819.70 | $5,128.61 |
AllWays Health Partners Setting Professional Modifier None Typical Low $316.23 Median $724.44 Typical High $2,818.38 | Professional | None | $316.23 | $724.44 | $2,818.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $302.00 Median $371.54 Typical High $691.83 | Facility | None | $302.00 | $371.54 | $691.83 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $776.25 | Professional | None | $524.81 | $524.81 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,949.84 Typical High $2,818.38 | Facility | None | $588.84 | $1,949.84 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $1,071.52 | Professional | None | $371.54 | $489.78 | $1,071.52 |
Fallon Health Setting Facility Modifier None Typical Low $302.00 Median $398.11 Typical High $3,311.31 | Facility | None | $302.00 | $398.11 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $691.83 | Professional | None | $467.74 | $562.34 | $691.83 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $331.13 Median $645.65 Typical High $1,230.27 | Professional | None | $331.13 | $645.65 | $1,230.27 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $1,819.70 Typical High $5,128.61 | Facility | None | $457.09 | $1,819.70 | $5,128.61 |
Mass General Brigham Setting Professional Modifier None Typical Low $316.23 Median $724.44 Typical High $2,818.38 | Professional | None | $316.23 | $724.44 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $1,659.59 | Professional | None | $371.54 | $549.54 | $1,659.59 |
Well Sense Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $891.25 | Facility | None | $263.03 | $398.11 | $891.25 |
Well Sense Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $331.13 | Professional | None | $218.78 | $263.03 | $331.13 |
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 $158.49 Median $204.17 Typical High $436.52 | Professional | 52 · Reduced service | $158.49 | $204.17 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $81.28 Typical High $173.78 | Professional | 53 · Discontinued | $63.10 | $81.28 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $302.00 Typical High $645.65 | Professional | 54 · Surgery only | $234.42 | $302.00 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $60.26 Typical High $128.82 | Professional | 55 · Aftercare only | $47.86 | $60.26 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $40.74 Typical High $87.10 | Professional | 56 · Pre-op care only | $31.62 | $40.74 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $281.84 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $218.78 | $281.84 | $602.56 |
Where Massachusetts sits
The same service costs 4.9 times more in Alaska 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· 14th of 51
$589
AK $1,479UT $302
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.