How much rates vary
Facilitymedian $132 · 10th to 90th $52 to $2,512Professionalmedian $132 · 10th to 90th $72 to $363
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 $398.11 Median $2,187.76 Typical High $3,630.78 | Facility | None | $398.11 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $234.42 | Professional | None | $79.43 | $141.25 | $234.42 |
AllWays Health Partners Setting Facility Modifier None Typical Low $53.70 Median $660.69 Typical High $2,454.71 | Facility | None | $53.70 | $660.69 | $2,454.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $69.18 Median $141.25 Typical High $1,148.15 | Professional | None | $69.18 | $141.25 | $1,148.15 |
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 $104.71 Typical High $239.88 | Professional | None | $52.48 | $104.71 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $489.78 | Facility | None | $75.86 | $100.00 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $218.78 | Professional | None | $75.86 | $123.03 | $218.78 |
Fallon Health Setting Facility Modifier None Typical Low $53.70 Median $70.79 Typical High $3,311.31 | Facility | None | $53.70 | $70.79 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $154.88 | Professional | None | $114.82 | $134.90 | $154.88 |
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 $69.18 Median $131.83 Typical High $263.03 | Professional | None | $69.18 | $131.83 | $263.03 |
Health New England Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $630.96 | Facility | None | $281.84 | $281.84 | $630.96 |
Health New England Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Mass General Brigham Setting Facility Modifier None Typical Low $53.70 Median $660.69 Typical High $2,454.71 | Facility | None | $53.70 | $660.69 | $2,454.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $69.18 Median $141.25 Typical High $1,148.15 | Professional | None | $69.18 | $141.25 | $1,148.15 |
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 $72.44 Median $131.83 Typical High $263.03 | Professional | None | $72.44 | $131.83 | $263.03 |
Well Sense Setting Facility Modifier None Typical Low $37.15 Median $66.07 Typical High $104.71 | Facility | None | $37.15 | $66.07 | $104.71 |
Well Sense Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $120.23 | Professional | None | $52.48 | $70.79 | $120.23 |
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 $39.81 Median $79.43 Typical High $102.33 | Professional | 52 · Reduced service | $39.81 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $31.62 Typical High $40.74 | Professional | 53 · Discontinued | $15.85 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $60.26 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $23.99 Typical High $30.20 | Professional | 55 · Aftercare only | $12.02 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $15.85 Typical High $20.42 | Professional | 56 · Pre-op care only | $7.94 | $15.85 | $20.42 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.88 Median $51.29 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $33.88 | $51.29 | $87.10 |
Where Massachusetts sits
The same service costs 3.2 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· 13th of 51
$132
AK $224KY $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.