How much rates vary
Facilitymedian $135 · 10th to 90th $59 to $1,820Professionalmedian $170 · 10th to 90th $87 to $525
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 $112.20 Median $2,691.53 Typical High $5,128.61 | Facility | None | $112.20 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $213.80 | Professional | None | $87.10 | $112.20 | $213.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $58.88 Median $309.03 Typical High $1,862.09 | Facility | None | $58.88 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $93.33 Median $229.09 Typical High $912.01 | Professional | None | $93.33 | $229.09 | $912.01 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $218.78 | Facility | None | $95.50 | $95.50 | $218.78 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $81.28 Median $93.33 Typical High $141.25 | Professional | None | $81.28 | $93.33 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $151.36 Typical High $489.78 | Facility | None | $100.00 | $151.36 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $331.13 | Professional | None | $123.03 | $165.96 | $331.13 |
Fallon Health Setting Facility Modifier None Typical Low $54.95 Median $104.71 Typical High $478.63 | Facility | None | $54.95 | $104.71 | $478.63 |
Fallon Health Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $199.53 | Professional | None | $79.43 | $138.04 | $199.53 |
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 $100.00 Median $204.17 Typical High $354.81 | Professional | None | $100.00 | $204.17 | $354.81 |
Health New England Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $58.88 Median $309.03 Typical High $1,862.09 | Facility | None | $58.88 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $93.33 Median $229.09 Typical High $912.01 | Professional | None | $93.33 | $229.09 | $912.01 |
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 $100.00 Median $169.82 Typical High $371.54 | Professional | None | $100.00 | $169.82 | $371.54 |
Well Sense Setting Facility Modifier None Typical Low $58.88 Median $97.72 Typical High $151.36 | Facility | None | $58.88 | $97.72 | $151.36 |
Well Sense Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $107.15 | Professional | None | $67.61 | $81.28 | $107.15 |
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 $43.65 Median $56.23 Typical High $138.04 | Professional | 52 · Reduced service | $43.65 | $56.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.39 Typical High $54.95 | Professional | 53 · Discontinued | $17.38 | $22.39 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $85.11 Typical High $204.17 | Professional | 54 · Surgery only | $64.57 | $85.11 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.98 Typical High $40.74 | Professional | 55 · Aftercare only | $13.18 | $16.98 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.22 Typical High $27.54 | Professional | 56 · Pre-op care only | $8.71 | $11.22 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $79.43 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $61.66 | $79.43 | $190.55 |
Where Massachusetts sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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· 12th of 51
$166
AK $355PA $107
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.