How much rates vary
Facilitymedian $380 · 10th to 90th $209 to $2,512Professionalmedian $468 · 10th to 90th $245 to $1,148
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 $1,000.00 Median $2,187.76 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $794.33 | Professional | None | $234.42 | $302.00 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $208.93 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $165.96 | $208.93 | $741.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $295.12 Median $575.44 Typical High $1,949.84 | Facility | None | $295.12 | $575.44 | $1,949.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $281.84 Median $562.34 Typical High $2,818.38 | Professional | None | $281.84 | $562.34 | $2,818.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $524.81 | Facility | None | $234.42 | $281.84 | $524.81 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $616.60 | Professional | None | $234.42 | $354.81 | $616.60 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $281.84 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $186.21 | $281.84 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $363.08 Typical High $489.78 | Facility | None | $199.53 | $363.08 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $831.76 | Professional | None | $346.74 | $457.09 | $831.76 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $3,311.31 | Facility | None | $177.83 | $288.40 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $616.60 | Professional | None | $371.54 | $446.68 | $616.60 |
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 $295.12 Median $537.03 Typical High $870.96 | Professional | None | $295.12 | $537.03 | $870.96 |
Health New England Setting Facility Modifier None Typical Low $194.98 Median $213.80 Typical High $251.19 | Facility | None | $194.98 | $213.80 | $251.19 |
Health New England Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $512.86 | Professional | None | $346.74 | $416.87 | $512.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $295.12 Median $575.44 Typical High $1,949.84 | Facility | None | $295.12 | $575.44 | $1,949.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $281.84 Median $562.34 Typical High $2,818.38 | Professional | None | $281.84 | $562.34 | $2,818.38 |
Tufts Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $588.84 | Professional | None | $245.47 | $436.52 | $588.84 |
United Setting Facility Modifier None Typical Low $407.38 Median $851.14 Typical High $4,168.69 | Facility | None | $407.38 | $851.14 | $4,168.69 |
United Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $912.01 | Professional | None | $288.40 | $457.09 | $912.01 |
Well Sense Setting Facility Modifier None Typical Low $162.18 Median $251.19 Typical High $416.87 | Facility | None | $162.18 | $251.19 | $416.87 |
Well Sense Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $380.19 | Professional | None | $288.40 | $316.23 | $380.19 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $239.88 |
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 $117.49 Median $151.36 Typical High $537.03 | Professional | 52 · Reduced service | $117.49 | $151.36 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $60.26 Typical High $213.80 | Professional | 53 · Discontinued | $47.86 | $60.26 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $223.87 Typical High $794.33 | Professional | 54 · Surgery only | $177.83 | $223.87 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $45.71 Typical High $158.49 | Professional | 55 · Aftercare only | $35.48 | $45.71 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $30.20 Typical High $107.15 | Professional | 56 · Pre-op care only | $23.44 | $30.20 | $107.15 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $100.00 Typical High $131.83 | Professional | 53 · Discontinued | $57.54 | $100.00 | $131.83 |
Where Massachusetts sits
The same service costs 4.2 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
$468
AK $955UT $229
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.