How much rates vary
Facilitymedian $72 · 10th to 90th $21 to $1,862Professionalmedian $91 · 10th to 90th $40 to $347
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 $89.13 Median $2,137.96 Typical High $3,388.44 | Facility | None | $89.13 | $2,137.96 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $89.13 Typical High $138.04 | Professional | None | $45.71 | $89.13 | $138.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $309.03 Typical High $1,862.09 | Facility | None | $50.12 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $38.90 Median $114.82 Typical High $691.83 | Professional | None | $38.90 | $114.82 | $691.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $66.07 | Facility | None | $28.18 | $28.18 | $66.07 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $28.18 Median $93.33 Typical High $165.96 | Professional | None | $28.18 | $93.33 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $100.00 Typical High $109.65 | Facility | None | $53.70 | $100.00 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $107.15 Typical High $194.98 | Professional | None | $39.81 | $107.15 | $194.98 |
Fallon Health Setting Facility Modifier None Typical Low $16.22 Median $32.36 Typical High $218.78 | Facility | None | $16.22 | $32.36 | $218.78 |
Fallon Health Setting Professional Modifier None Typical Low $51.29 Median $89.13 Typical High $128.82 | Professional | None | $51.29 | $89.13 | $128.82 |
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 $34.67 Median $95.50 Typical High $223.87 | Professional | None | $34.67 | $95.50 | $223.87 |
Health New England Setting Facility Modifier None Typical Low $309.03 Median $346.74 Typical High $660.69 | Facility | None | $309.03 | $346.74 | $660.69 |
Health New England Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $309.03 Typical High $1,862.09 | Facility | None | $50.12 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $38.90 Median $114.82 Typical High $691.83 | Professional | None | $38.90 | $114.82 | $691.83 |
Tufts Setting Facility Modifier None Typical Low $239.88 Median $426.58 Typical High $758.58 | Facility | None | $239.88 | $426.58 | $758.58 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $40.74 Median $97.72 Typical High $234.42 | Professional | None | $40.74 | $97.72 | $234.42 |
Well Sense Setting Facility Modifier None Typical Low $26.30 Median $48.98 Typical High $89.13 | Facility | None | $26.30 | $48.98 | $89.13 |
Well Sense Setting Professional Modifier None Typical Low $34.67 Median $41.69 Typical High $83.18 | Professional | None | $34.67 | $41.69 | $83.18 |
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 $22.91 Median $44.67 Typical High $69.18 | Professional | 52 · Reduced service | $22.91 | $44.67 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $17.78 Typical High $27.54 | Professional | 53 · Discontinued | $9.12 | $17.78 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $66.07 Typical High $102.33 | Professional | 54 · Surgery only | $33.88 | $66.07 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $13.18 Typical High $20.42 | Professional | 55 · Aftercare only | $6.92 | $13.18 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $8.91 Typical High $13.80 | Professional | 56 · Pre-op care only | $4.57 | $8.91 | $13.80 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $22.91 Median $38.90 Typical High $60.26 | Professional | 78 · Unplanned return to OR | $22.91 | $38.90 | $60.26 |
Where Massachusetts sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 22nd of 51
$89.13
WI $186NE $60.26
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.