How much rates vary
Facilitymedian $355 · 10th to 90th $102 to $3,311Professionalmedian $295 · 10th to 90th $105 to $1,995
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $234.42 Typical High $251.19 | Professional | None | $97.72 | $234.42 | $251.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $223.87 Median $1,000.00 Typical High $3,548.13 | Facility | None | $223.87 | $1,000.00 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $114.82 Median $338.84 Typical High $1,995.26 | Professional | None | $114.82 | $338.84 | $1,995.26 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $234.42 | Facility | None | $102.33 | $102.33 | $234.42 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | None | $512.86 | $512.86 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $380.19 Typical High $489.78 | Facility | None | $100.00 | $380.19 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $257.04 Typical High $616.60 | Professional | None | $87.10 | $257.04 | $616.60 |
Fallon Health Setting Facility Modifier None Typical Low $91.20 Median $128.82 Typical High $3,311.31 | Facility | None | $91.20 | $128.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $501.19 | Professional | None | $302.00 | $371.54 | $501.19 |
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 $117.49 Median $288.40 Typical High $707.95 | Professional | None | $117.49 | $288.40 | $707.95 |
Mass General Brigham Setting Facility Modifier None Typical Low $223.87 Median $1,000.00 Typical High $3,548.13 | Facility | None | $223.87 | $1,000.00 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $114.82 Median $338.84 Typical High $1,995.26 | Professional | None | $114.82 | $338.84 | $1,995.26 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $5,128.61 | Facility | None | $575.44 | $1,380.38 | $5,128.61 |
United Setting Professional Modifier None Typical Low $117.49 Median $288.40 Typical High $707.95 | Professional | None | $117.49 | $288.40 | $707.95 |
Well Sense Setting Facility Modifier None Typical Low $89.13 Median $169.82 Typical High $309.03 | Facility | None | $89.13 | $169.82 | $309.03 |
Well Sense Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $190.55 | Professional | None | $67.61 | $91.20 | $190.55 |
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 $48.98 Median $117.49 Typical High $125.89 | Professional | 52 · Reduced service | $48.98 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $19.95 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $173.78 Typical High $190.55 | Professional | 54 · Surgery only | $74.13 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $35.48 Typical High $38.02 | Professional | 55 · Aftercare only | $14.79 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $23.44 Typical High $25.12 | Professional | 56 · Pre-op care only | $9.77 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $162.18 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $69.18 | $162.18 | $177.83 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $43.65 Median $58.88 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $43.65 | $58.88 | $123.03 |
Where Massachusetts sits
The same service costs 5.6 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· 9th of 51
$295
AK $562KY $100
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.