How much rates vary
Facilitymedian $562 · 10th to 90th $138 to $3,981Professionalmedian $316 · 10th to 90th $182 to $2,344
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 $645.65 Median $2,691.53 Typical High $3,715.35 | Facility | None | $645.65 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $562.34 | Professional | None | $190.55 | $213.80 | $562.34 |
AllWays Health Partners Setting Facility Modifier None Typical Low $446.68 Median $2,041.74 Typical High $5,888.44 | Facility | None | $446.68 | $2,041.74 | $5,888.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $190.55 Median $457.09 Typical High $2,344.23 | Professional | None | $190.55 | $457.09 | $2,344.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $436.52 | Facility | None | $190.55 | $190.55 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,187.76 Typical High $3,311.31 | Facility | None | $645.65 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $645.65 | Professional | None | $251.19 | $295.12 | $645.65 |
Fallon Health Setting Facility Modifier None Typical Low $109.65 Median $218.78 Typical High $1,905.46 | Facility | None | $109.65 | $218.78 | $1,905.46 |
Fallon Health Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $354.81 | Professional | None | $138.04 | $245.47 | $354.81 |
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 $204.17 Median $398.11 Typical High $724.44 | Professional | None | $204.17 | $398.11 | $724.44 |
Health New England Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $446.68 Median $2,041.74 Typical High $5,888.44 | Facility | None | $446.68 | $2,041.74 | $5,888.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $190.55 Median $457.09 Typical High $2,344.23 | Professional | None | $190.55 | $457.09 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,332.54 | Facility | None | $1,047.13 | $2,344.23 | $9,332.54 |
United Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $831.76 | Professional | None | $208.93 | $302.00 | $831.76 |
Well Sense Setting Facility Modifier None Typical Low $158.49 Median $223.87 Typical High $676.08 | Facility | None | $158.49 | $223.87 | $676.08 |
Well Sense Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $194.98 | Professional | None | $144.54 | $162.18 | $194.98 |
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 $95.50 Median $107.15 Typical High $281.84 | Professional | 52 · Reduced service | $95.50 | $107.15 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $42.66 Typical High $112.20 | Professional | 53 · Discontinued | $38.02 | $42.66 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $162.18 Typical High $426.58 | Professional | 54 · Surgery only | $141.25 | $162.18 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $32.36 Typical High $85.11 | Professional | 55 · Aftercare only | $28.18 | $32.36 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.38 Typical High $56.23 | Professional | 56 · Pre-op care only | $19.05 | $21.38 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $151.36 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $131.83 | $151.36 | $398.11 |
Where Massachusetts sits
The same service costs 5.9 times more in Oklahoma 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· 19th of 51
$324
OK $1,175UT $200
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.