How much rates vary
Facilitymedian $380 · 10th to 90th $158 to $2,570Professionalmedian $363 · 10th to 90th $166 to $955
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $416.87 | Professional | None | $158.49 | $251.19 | $416.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $338.84 Median $602.56 Typical High $2,344.23 | Facility | None | $338.84 | $602.56 | $2,344.23 |
AllWays Health Partners Setting Professional Modifier None Typical Low $173.78 Median $389.05 Typical High $1,862.09 | Professional | None | $173.78 | $389.05 | $1,862.09 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $354.81 | Facility | None | $154.88 | $154.88 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $645.65 Typical High $933.25 | Facility | None | $199.53 | $645.65 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $602.56 | Professional | None | $218.78 | $338.84 | $602.56 |
Fallon Health Setting Facility Modifier None Typical Low $154.88 Median $199.53 Typical High $3,311.31 | Facility | None | $154.88 | $199.53 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $436.52 | Professional | None | $323.59 | $371.54 | $436.52 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $181.97 Median $363.08 Typical High $741.31 | Professional | None | $181.97 | $363.08 | $741.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $338.84 Median $602.56 Typical High $2,344.23 | Facility | None | $338.84 | $602.56 | $2,344.23 |
Mass General Brigham Setting Professional Modifier None Typical Low $173.78 Median $389.05 Typical High $1,862.09 | Professional | None | $173.78 | $389.05 | $1,862.09 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $758.58 | Professional | None | $194.98 | $338.84 | $758.58 |
Well Sense Setting Facility Modifier None Typical Low $141.25 Median $245.47 Typical High $363.08 | Facility | None | $141.25 | $245.47 | $363.08 |
Well Sense Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $257.04 | Professional | None | $107.15 | $144.54 | $257.04 |
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 $79.43 Median $125.89 Typical High $204.17 | Professional | 52 · Reduced service | $79.43 | $125.89 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $50.12 Typical High $83.18 | Professional | 53 · Discontinued | $31.62 | $50.12 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $186.21 Typical High $309.03 | Professional | 54 · Surgery only | $120.23 | $186.21 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $37.15 Typical High $61.66 | Professional | 55 · Aftercare only | $23.99 | $37.15 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $25.12 Typical High $41.69 | Professional | 56 · Pre-op care only | $15.85 | $25.12 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $173.78 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $112.20 | $173.78 | $288.40 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $102.33 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $69.18 | $102.33 | $186.21 |
Where Massachusetts sits
The same service costs 4.2 times more in Alaska than in Virginia. 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· 10th of 51
$363
AK $776VA $186
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.