How much rates vary
Facilitymedian $457 · 10th to 90th $204 to $2,818Professionalmedian $380 · 10th to 90th $200 to $1,000
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 $676.08 Median $2,691.53 Typical High $3,715.35 | Facility | None | $676.08 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $549.54 | Professional | None | $199.53 | $245.47 | $549.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $2,454.71 | Facility | None | $354.81 | $660.69 | $2,454.71 |
AllWays Health Partners Setting Professional Modifier None Typical Low $199.53 Median $457.09 Typical High $2,041.74 | Professional | None | $199.53 | $457.09 | $2,041.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $204.17 Median $251.19 Typical High $467.74 | Facility | None | $204.17 | $251.19 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $776.25 Typical High $977.24 | Facility | None | $100.00 | $776.25 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $645.65 | Professional | None | $269.15 | $371.54 | $645.65 |
Fallon Health Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $3,311.31 | Facility | None | $204.17 | $269.15 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $467.74 | Professional | None | $354.81 | $407.38 | $467.74 |
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 $223.87 Median $446.68 Typical High $831.76 | Professional | None | $223.87 | $446.68 | $831.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $2,454.71 | Facility | None | $354.81 | $660.69 | $2,454.71 |
Mass General Brigham Setting Professional Modifier None Typical Low $199.53 Median $457.09 Typical High $2,041.74 | Professional | None | $199.53 | $457.09 | $2,041.74 |
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 $223.87 Median $331.13 Typical High $891.25 | Professional | None | $223.87 | $331.13 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $169.82 Median $269.15 Typical High $380.19 | Facility | None | $169.82 | $269.15 | $380.19 |
Well Sense Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $199.53 | Professional | None | $138.04 | $165.96 | $199.53 |
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 $100.00 Median $123.03 Typical High $275.42 | Professional | 52 · Reduced service | $100.00 | $123.03 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $48.98 Typical High $109.65 | Professional | 53 · Discontinued | $39.81 | $48.98 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $181.97 Typical High $407.38 | Professional | 54 · Surgery only | $151.36 | $181.97 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $36.31 Typical High $81.28 | Professional | 55 · Aftercare only | $30.20 | $36.31 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $24.55 Typical High $54.95 | Professional | 56 · Pre-op care only | $19.95 | $24.55 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $169.82 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $141.25 | $169.82 | $380.19 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $107.15 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $89.13 | $107.15 | $144.54 |
Where Massachusetts sits
The same service costs 4.3 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· 10th of 51
$389
AK $912KY $214
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.