How much rates vary
Facilitymedian $191 · 10th to 90th $69 to $3,890Professionalmedian $219 · 10th to 90th $117 to $1,230
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 $389.05 Median $2,691.53 Typical High $3,715.35 | Facility | None | $389.05 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $309.03 | Professional | None | $117.49 | $134.90 | $309.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $251.19 Median $1,737.80 Typical High $4,897.79 | Facility | None | $251.19 | $1,737.80 | $4,897.79 |
AllWays Health Partners Setting Professional Modifier None Typical Low $128.82 Median $275.42 Typical High $1,230.27 | Professional | None | $128.82 | $275.42 | $1,230.27 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $257.04 | Facility | None | $112.20 | $138.04 | $257.04 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $151.36 Median $295.12 Typical High $537.03 | Professional | None | $151.36 | $295.12 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $169.82 Typical High $831.76 | Facility | None | $100.00 | $169.82 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $426.58 | Professional | None | $131.83 | $194.98 | $426.58 |
Fallon Health Setting Facility Modifier None Typical Low $64.57 Median $125.89 Typical High $302.00 | Facility | None | $64.57 | $125.89 | $302.00 |
Fallon Health Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $269.15 | Professional | None | $104.71 | $186.21 | $269.15 |
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 $125.89 Median $251.19 Typical High $501.19 | Professional | None | $125.89 | $251.19 | $501.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $251.19 Median $1,737.80 Typical High $4,897.79 | Facility | None | $251.19 | $1,737.80 | $4,897.79 |
Mass General Brigham Setting Professional Modifier None Typical Low $128.82 Median $275.42 Typical High $1,230.27 | Professional | None | $128.82 | $275.42 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $501.19 | Professional | None | $147.91 | $208.93 | $501.19 |
Well Sense Setting Facility Modifier None Typical Low $66.07 Median $125.89 Typical High $194.98 | Facility | None | $66.07 | $125.89 | $194.98 |
Well Sense Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $117.49 | Professional | None | $83.18 | $97.72 | $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 $58.88 Median $67.61 Typical High $165.96 | Professional | 52 · Reduced service | $58.88 | $67.61 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.92 Typical High $66.07 | Professional | 53 · Discontinued | $23.44 | $26.92 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $100.00 Typical High $251.19 | Professional | 54 · Surgery only | $87.10 | $100.00 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.95 Typical High $50.12 | Professional | 55 · Aftercare only | $17.78 | $19.95 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.49 Typical High $33.11 | Professional | 56 · Pre-op care only | $11.75 | $13.49 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $93.33 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $81.28 | $93.33 | $234.42 |
Where Massachusetts sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 15th of 51
$219
WI $468TX $129
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.