How much rates vary
Facilitymedian $513 · 10th to 90th $219 to $3,311Professionalmedian $417 · 10th to 90th $251 to $2,089
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 $537.03 Median $2,137.96 Typical High $3,630.78 | Facility | None | $537.03 | $2,137.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $588.84 | Professional | None | $251.19 | $323.59 | $588.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $1,071.52 Typical High $3,311.31 | Facility | None | $354.81 | $1,071.52 | $3,311.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $223.87 Median $512.86 Typical High $2,089.30 | Professional | None | $223.87 | $512.86 | $2,089.30 |
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 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $741.31 | Professional | None | $331.13 | $489.78 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $870.96 Typical High $1,288.25 | Facility | None | $446.68 | $870.96 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $776.25 | Professional | None | $263.03 | $363.08 | $776.25 |
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 $338.84 Median $407.38 Typical High $501.19 | Professional | None | $338.84 | $407.38 | $501.19 |
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 $245.47 Median $478.63 Typical High $891.25 | Professional | None | $245.47 | $478.63 | $891.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $1,071.52 Typical High $3,311.31 | Facility | None | $354.81 | $1,071.52 | $3,311.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $223.87 Median $512.86 Typical High $2,089.30 | Professional | None | $223.87 | $512.86 | $2,089.30 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,165.95 | Facility | None | $575.44 | $1,380.38 | $6,165.95 |
United Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $1,202.26 | Professional | None | $281.84 | $398.11 | $1,202.26 |
Well Sense Setting Facility Modifier None Typical Low $181.97 Median $281.84 Typical High $457.09 | Facility | None | $181.97 | $281.84 | $457.09 |
Well Sense Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $263.03 | Professional | None | $169.82 | $204.17 | $263.03 |
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 $123.03 Median $165.96 Typical High $331.13 | Professional | 52 · Reduced service | $123.03 | $165.96 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $66.07 Typical High $134.90 | Professional | 53 · Discontinued | $50.12 | $66.07 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $251.19 Typical High $501.19 | Professional | 54 · Surgery only | $186.21 | $251.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $50.12 Typical High $100.00 | Professional | 55 · Aftercare only | $37.15 | $50.12 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $33.11 Typical High $67.61 | Professional | 56 · Pre-op care only | $25.12 | $33.11 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $234.42 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $173.78 | $234.42 | $467.74 |
Where Massachusetts sits
The same service costs 4.3 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· 15th of 51
$437
AK $1,000UT $234
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.