How much rates vary
Facilitymedian $155 · 10th to 90th $68 to $1,862Professionalmedian $209 · 10th to 90th $110 to $661
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 $138.04 Median $2,691.53 Typical High $5,128.61 | Facility | None | $138.04 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $263.03 | Professional | None | $109.65 | $138.04 | $263.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $83.18 Median $389.05 Typical High $1,862.09 | Facility | None | $83.18 | $389.05 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $112.20 Median $269.15 Typical High $1,096.48 | Professional | None | $112.20 | $269.15 | $1,096.48 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $257.04 | Facility | None | $112.20 | $112.20 | $257.04 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $169.82 | Professional | None | $95.50 | $109.65 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $100.00 | Facility | None | $50.12 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $407.38 | Professional | None | $151.36 | $208.93 | $407.38 |
Fallon Health Setting Facility Modifier None Typical Low $64.57 Median $123.03 Typical High $302.00 | Facility | None | $64.57 | $123.03 | $302.00 |
Fallon Health Setting Professional Modifier None Typical Low $95.50 Median $165.96 Typical High $239.88 | Professional | None | $95.50 | $165.96 | $239.88 |
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 $117.49 Median $239.88 Typical High $436.52 | Professional | None | $117.49 | $239.88 | $436.52 |
Mass General Brigham Setting Facility Modifier None Typical Low $83.18 Median $389.05 Typical High $1,862.09 | Facility | None | $83.18 | $389.05 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $112.20 Median $269.15 Typical High $1,096.48 | Professional | None | $112.20 | $269.15 | $1,096.48 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $457.09 | Professional | None | $120.23 | $199.53 | $457.09 |
Well Sense Setting Facility Modifier None Typical Low $81.28 Median $123.03 Typical High $190.55 | Facility | None | $81.28 | $123.03 | $190.55 |
Well Sense Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $117.49 | Professional | None | $77.62 | $93.33 | $117.49 |
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 $54.95 Median $69.18 Typical High $151.36 | Professional | 52 · Reduced service | $54.95 | $69.18 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $27.54 Typical High $60.26 | Professional | 53 · Discontinued | $21.88 | $27.54 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $104.71 Typical High $229.09 | Professional | 54 · Surgery only | $83.18 | $104.71 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.89 Typical High $45.71 | Professional | 55 · Aftercare only | $16.60 | $20.89 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.80 Typical High $30.20 | Professional | 56 · Pre-op care only | $10.96 | $13.80 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $97.72 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $77.62 | $97.72 | $213.80 |
Where Massachusetts sits
The same service costs 4.2 times more in Alaska 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· 11th of 51
$204
AK $437KY $105
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.