How much rates vary
Facilitymedian $813 · 10th to 90th $355 to $5,248Professionalmedian $794 · 10th to 90th $417 to $8,318
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 $1,621.81 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,621.81 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,621.81 | Professional | None | $537.03 | $537.03 | $1,621.81 |
AllWays Health Partners Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $6,165.95 | Facility | None | $524.81 | $1,659.59 | $6,165.95 |
AllWays Health Partners Setting Professional Modifier None Typical Low $549.54 Median $1,513.56 Typical High $8,317.64 | Professional | None | $549.54 | $1,513.56 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $831.76 Typical High $954.99 | Facility | None | $50.12 | $831.76 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,737.80 | Professional | None | $645.65 | $645.65 | $1,737.80 |
Fallon Health Setting Facility Modifier None Typical Low $323.59 Median $630.96 Typical High $2,691.53 | Facility | None | $323.59 | $630.96 | $2,691.53 |
Fallon Health Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $812.83 | Professional | None | $316.23 | $562.34 | $812.83 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,659.59 | Professional | None | $602.56 | $1,071.52 | $1,659.59 |
Mass General Brigham Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $6,165.95 | Facility | None | $524.81 | $1,659.59 | $6,165.95 |
Mass General Brigham Setting Professional Modifier None Typical Low $549.54 Median $1,513.56 Typical High $8,317.64 | Professional | None | $549.54 | $1,513.56 | $8,317.64 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $7,244.36 | Facility | None | $851.14 | $2,290.87 | $7,244.36 |
United Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $2,089.30 | Professional | None | $602.56 | $794.33 | $2,089.30 |
Well Sense Setting Facility Modifier None Typical Low $416.87 Median $562.34 Typical High $851.14 | Facility | None | $416.87 | $562.34 | $851.14 |
Well Sense Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | None | $407.38 | $407.38 | $489.78 |
7 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 $269.15 Median $269.15 Typical High $812.83 | Professional | 52 · Reduced service | $269.15 | $269.15 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $323.59 | Professional | 53 · Discontinued | $107.15 | $107.15 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $1,230.27 | Professional | 54 · Surgery only | $398.11 | $398.11 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $245.47 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $162.18 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $1,148.15 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $562.34 Typical High $891.25 | Professional | 52 · Reduced service | $371.54 | $562.34 | $891.25 |
Where Massachusetts sits
The same service costs 6.0 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· 24th of 51
$813
AK $2,239UT $372
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.