How much rates vary
Facilitymedian $490 · 10th to 90th $170 to $3,311Professionalmedian $295 · 10th to 90th $145 to $1,380
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 $467.74 Median $2,187.76 Typical High $3,630.78 | Facility | None | $467.74 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $416.87 | Professional | None | $102.33 | $114.82 | $416.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $1,071.52 Typical High $3,311.31 | Facility | None | $354.81 | $1,071.52 | $3,311.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $165.96 Median $398.11 Typical High $1,380.38 | Professional | None | $165.96 | $398.11 | $1,380.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $169.82 Median $204.17 Typical High $389.05 | Facility | None | $169.82 | $204.17 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $870.96 Typical High $1,288.25 | Facility | None | $446.68 | $870.96 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $575.44 | Professional | None | $269.15 | $316.23 | $575.44 |
Fallon Health Setting Facility Modifier None Typical Low $165.96 Median $218.78 Typical High $3,311.31 | Facility | None | $165.96 | $218.78 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $338.84 | Professional | None | $229.09 | $275.42 | $338.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $177.83 Median $346.74 Typical High $575.44 | Professional | None | $177.83 | $346.74 | $575.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $1,071.52 Typical High $3,311.31 | Facility | None | $354.81 | $1,071.52 | $3,311.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $165.96 Median $398.11 Typical High $1,380.38 | Professional | None | $165.96 | $398.11 | $1,380.38 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,165.95 | Facility | None | $575.44 | $1,380.38 | $6,165.95 |
United Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $645.65 | Professional | None | $173.78 | $245.47 | $645.65 |
Well Sense Setting Facility Modifier None Typical Low $141.25 Median $199.53 Typical High $457.09 | Facility | None | $141.25 | $199.53 | $457.09 |
Well Sense Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $141.25 | Professional | None | $107.15 | $117.49 | $141.25 |
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 $51.29 Median $57.54 Typical High $208.93 | Professional | 52 · Reduced service | $51.29 | $57.54 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.91 Typical High $83.18 | Professional | 53 · Discontinued | $20.89 | $22.91 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $87.10 Typical High $316.23 | Professional | 54 · Surgery only | $77.62 | $87.10 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.38 Typical High $63.10 | Professional | 55 · Aftercare only | $15.49 | $17.38 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.48 Typical High $41.69 | Professional | 56 · Pre-op care only | $10.23 | $11.48 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $81.28 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $72.44 | $81.28 | $295.12 |
Where Massachusetts sits
The same service costs 4.6 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· 9th of 51
$316
AK $759UT $166
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.