How much rates vary
Facilitymedian $115 · 10th to 90th $50 to $2,042Professionalmedian $115 · 10th to 90th $65 to $269
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 $107.15 Median $2,137.96 Typical High $3,388.44 | Facility | None | $107.15 | $2,137.96 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $107.15 Typical High $199.53 | Professional | None | $64.57 | $107.15 | $199.53 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $309.03 Typical High $1,862.09 | Facility | None | $50.12 | $309.03 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $56.23 Median $125.89 Typical High $1,148.15 | Professional | None | $56.23 | $125.89 | $1,148.15 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $117.49 | Facility | None | $50.12 | $50.12 | $117.49 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $50.12 Median $91.20 Typical High $204.17 | Professional | None | $50.12 | $91.20 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $89.13 Typical High $489.78 | Facility | None | $61.66 | $89.13 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $181.97 | Professional | None | $72.44 | $107.15 | $181.97 |
Fallon Health Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $3,311.31 | Facility | None | $50.12 | $66.07 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $134.90 | Professional | None | $100.00 | $114.82 | $134.90 |
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 $120.23 Typical High $239.88 | Professional | None | $64.57 | $120.23 | $239.88 |
Health New England Setting Facility Modifier None Typical Low $234.42 Median $588.84 Typical High $891.25 | Facility | None | $234.42 | $588.84 | $891.25 |
Health New England Setting Professional Modifier None Typical Low $58.88 Median $177.83 Typical High $208.93 | Professional | None | $58.88 | $177.83 | $208.93 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $309.03 Typical High $1,862.09 | Facility | None | $50.12 | $309.03 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $56.23 Median $125.89 Typical High $1,148.15 | Professional | None | $56.23 | $125.89 | $1,148.15 |
Tufts Setting Facility Modifier None Typical Low $38.02 Median $338.84 Typical High $549.54 | Facility | None | $38.02 | $338.84 | $549.54 |
Tufts Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $112.20 | Professional | None | $38.02 | $61.66 | $112.20 |
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 $69.18 Median $112.20 Typical High $251.19 | Professional | None | $69.18 | $112.20 | $251.19 |
Well Sense Setting Facility Modifier None Typical Low $28.18 Median $56.23 Typical High $89.13 | Facility | None | $28.18 | $56.23 | $89.13 |
Well Sense Setting Professional Modifier None Typical Low $54.95 Median $74.13 Typical High $95.50 | Professional | None | $54.95 | $74.13 | $95.50 |
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 $32.36 Median $53.70 Typical High $102.33 | Professional | 52 · Reduced service | $32.36 | $53.70 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $21.38 Typical High $40.74 | Professional | 53 · Discontinued | $12.88 | $21.38 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $81.28 Typical High $151.36 | Professional | 54 · Surgery only | $48.98 | $81.28 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $16.22 Typical High $30.90 | Professional | 55 · Aftercare only | $9.77 | $16.22 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.72 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.46 | $10.72 | $20.42 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $35.48 Median $50.12 Typical High $67.61 | Professional | 78 · Unplanned return to OR | $35.48 | $50.12 | $67.61 |
Where Massachusetts sits
The same service costs 3.2 times more in Alaska 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· 11th of 51
$115
AK $214TX $67.61
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.