How much rates vary
Facilitymedian $135 · 10th to 90th $52 to $2,138Professionalmedian $148 · 10th to 90th $68 to $417
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 $138.04 Median $2,137.96 Typical High $3,388.44 | Facility | None | $138.04 | $2,137.96 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $138.04 Typical High $177.83 | Professional | None | $72.44 | $138.04 | $177.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $64.57 Median $309.03 Typical High $1,862.09 | Facility | None | $64.57 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $56.23 Median $147.91 Typical High $1,023.29 | Professional | None | $56.23 | $147.91 | $1,023.29 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $123.03 | Facility | None | $52.48 | $52.48 | $123.03 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $52.48 Median $144.54 Typical High $281.84 | Professional | None | $52.48 | $144.54 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $169.82 Typical High $489.78 | Facility | None | $100.00 | $169.82 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $158.49 Typical High $281.84 | Professional | None | $72.44 | $158.49 | $281.84 |
Fallon Health Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $3,311.31 | Facility | None | $52.48 | $69.18 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $213.80 | Professional | None | $158.49 | $186.21 | $213.80 |
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 $64.57 Median $147.91 Typical High $338.84 | Professional | None | $64.57 | $147.91 | $338.84 |
Health New England Setting Facility Modifier None Typical Low $204.17 Median $467.74 Typical High $758.58 | Facility | None | $204.17 | $467.74 | $758.58 |
Health New England Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $309.03 | Professional | None | $181.97 | $208.93 | $309.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $64.57 Median $309.03 Typical High $1,862.09 | Facility | None | $64.57 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $56.23 Median $147.91 Typical High $1,023.29 | Professional | None | $56.23 | $147.91 | $1,023.29 |
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 $64.57 Median $144.54 Typical High $338.84 | Professional | None | $64.57 | $144.54 | $338.84 |
Well Sense Setting Facility Modifier None Typical Low $44.67 Median $74.13 Typical High $131.83 | Facility | None | $44.67 | $74.13 | $131.83 |
Well Sense Setting Professional Modifier None Typical Low $46.77 Median $63.10 Typical High $97.72 | Professional | None | $46.77 | $63.10 | $97.72 |
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 $36.31 Median $67.61 Typical High $87.10 | Professional | 52 · Reduced service | $36.31 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $27.54 Typical High $35.48 | Professional | 53 · Discontinued | $14.45 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $102.33 Typical High $131.83 | Professional | 54 · Surgery only | $54.95 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $20.42 Typical High $26.30 | Professional | 55 · Aftercare only | $10.96 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $13.80 Typical High $17.38 | Professional | 56 · Pre-op care only | $7.24 | $13.80 | $17.38 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.20 Median $44.67 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $30.20 | $44.67 | $70.79 |
Where Massachusetts sits
The same service costs 3.4 times more in Alaska than in Kentucky. 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
$145
AK $234KY $69.18
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.