How much rates vary
Facilitymedian $427 · 10th to 90th $129 to $2,239Professionalmedian $562 · 10th to 90th $324 to $1,318
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 $831.76 Median $2,187.76 Typical High $3,630.78 | Facility | None | $831.76 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $831.76 | Professional | None | $323.59 | $331.13 | $831.76 |
AllWays Health Partners Setting Facility Modifier None Typical Low $117.49 Median $436.52 Typical High $1,819.70 | Facility | None | $117.49 | $436.52 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $346.74 Median $776.25 Typical High $2,570.40 | Professional | None | $346.74 | $776.25 | $2,570.40 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $776.25 | Facility | None | $338.84 | $338.84 | $776.25 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $758.58 | Professional | None | $338.84 | $398.11 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $323.59 Typical High $446.68 | Facility | None | $53.70 | $323.59 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $1,148.15 | Professional | None | $281.84 | $512.86 | $1,148.15 |
Fallon Health Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $3,311.31 | Facility | None | $331.13 | $426.58 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $691.83 | Professional | None | $416.87 | $501.19 | $691.83 |
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 $346.74 Median $707.95 Typical High $1,000.00 | Professional | None | $346.74 | $707.95 | $1,000.00 |
Mass General Brigham Setting Facility Modifier None Typical Low $117.49 Median $436.52 Typical High $1,819.70 | Facility | None | $117.49 | $436.52 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $346.74 Median $776.25 Typical High $2,570.40 | Professional | None | $346.74 | $776.25 | $2,570.40 |
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 $331.13 Median $457.09 Typical High $1,202.26 | Professional | None | $331.13 | $457.09 | $1,202.26 |
Well Sense Setting Facility Modifier None Typical Low $117.49 Median $316.23 Typical High $562.34 | Facility | None | $117.49 | $316.23 | $562.34 |
Well Sense Setting Professional Modifier None Typical Low $218.78 Median $223.87 Typical High $269.15 | Professional | None | $218.78 | $223.87 | $269.15 |
8 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 $162.18 Median $165.96 Typical High $416.87 | Professional | 52 · Reduced service | $162.18 | $165.96 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $66.07 Typical High $165.96 | Professional | 53 · Discontinued | $64.57 | $66.07 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $616.60 | Professional | 54 · Surgery only | $245.47 | $245.47 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $125.89 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.11 Typical High $83.18 | Professional | 56 · Pre-op care only | $32.36 | $33.11 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $575.44 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $338.84 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $269.15 | $338.84 | $501.19 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $141.25 | $141.25 | $169.82 |
Where Massachusetts sits
The same service costs 7.4 times more in Hawaii than in Florida. 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.
Physician feeFacility fee
HI $3,255FL $440
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.