How much rates vary
Facilitymedian $603 · 10th to 90th $138 to $3,631Professionalmedian $275 · 10th to 90th $135 to $813
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 $501.19 Median $2,187.76 Typical High $3,630.78 | Facility | None | $501.19 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $338.84 | Professional | None | $131.83 | $190.55 | $338.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $4,265.80 | Facility | None | $323.59 | $1,258.93 | $4,265.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $151.36 Median $331.13 Typical High $1,479.11 | Professional | None | $151.36 | $331.13 | $1,479.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $131.83 Median $158.49 Typical High $302.00 | Facility | None | $131.83 | $158.49 | $302.00 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $131.83 Median $234.42 Typical High $416.87 | Professional | None | $131.83 | $234.42 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,398.83 | Facility | None | $446.68 | $1,659.59 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $302.00 Typical High $489.78 | Professional | None | $123.03 | $302.00 | $489.78 |
Fallon Health Setting Facility Modifier None Typical Low $128.82 Median $169.82 Typical High $3,311.31 | Facility | None | $128.82 | $169.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $407.38 | Professional | None | $245.47 | $302.00 | $407.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $154.88 Median $302.00 Typical High $562.34 | Professional | None | $154.88 | $302.00 | $562.34 |
Health New England Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Health New England Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $4,265.80 | Facility | None | $323.59 | $1,258.93 | $4,265.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $151.36 Median $331.13 Typical High $1,479.11 | Professional | None | $151.36 | $331.13 | $1,479.11 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $7,585.78 | Facility | None | $575.44 | $1,380.38 | $7,585.78 |
United Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $562.34 | Professional | None | $154.88 | $257.04 | $562.34 |
Well Sense Setting Facility Modifier None Typical Low $117.49 Median $204.17 Typical High $851.14 | Facility | None | $117.49 | $204.17 | $851.14 |
Well Sense Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $154.88 | Professional | None | $89.13 | $120.23 | $154.88 |
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 $66.07 Median $95.50 Typical High $169.82 | Professional | 52 · Reduced service | $66.07 | $95.50 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $38.02 Typical High $69.18 | Professional | 53 · Discontinued | $26.30 | $38.02 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $144.54 Typical High $257.04 | Professional | 54 · Surgery only | $100.00 | $144.54 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $28.84 Typical High $51.29 | Professional | 55 · Aftercare only | $19.95 | $28.84 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.05 Typical High $33.88 | Professional | 56 · Pre-op care only | $13.18 | $19.05 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $134.90 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $93.33 | $134.90 | $239.88 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $186.21 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $104.71 | $186.21 | $346.74 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $77.62 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $57.54 | $77.62 | $97.72 |
Where Massachusetts sits
The same service costs 4.7 times more in Alaska than in Utah. 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
$288
AK $708UT $151
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.