How much rates vary
Facilitymedian $562 · 10th to 90th $219 to $3,981Professionalmedian $525 · 10th to 90th $240 to $1,514
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 $691.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $691.83 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $630.96 | Professional | None | $239.88 | $371.54 | $630.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $489.78 Median $1,412.54 Typical High $4,265.80 | Facility | None | $489.78 | $1,412.54 | $4,265.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $288.40 Median $588.84 Typical High $3,630.78 | Professional | None | $288.40 | $588.84 | $3,630.78 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $501.19 | Facility | None | $223.87 | $269.15 | $501.19 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $223.87 Median $436.52 Typical High $758.58 | Professional | None | $223.87 | $436.52 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $457.09 Typical High $1,071.52 | Facility | None | $100.00 | $457.09 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $537.03 Typical High $891.25 | Professional | None | $213.80 | $537.03 | $891.25 |
Fallon Health Setting Facility Modifier None Typical Low $218.78 Median $288.40 Typical High $3,311.31 | Facility | None | $218.78 | $288.40 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $776.25 | Professional | None | $467.74 | $562.34 | $776.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $1,071.52 | Professional | None | $288.40 | $524.81 | $1,071.52 |
Mass General Brigham Setting Facility Modifier None Typical Low $489.78 Median $1,412.54 Typical High $4,265.80 | Facility | None | $489.78 | $1,412.54 | $4,265.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $288.40 Median $588.84 Typical High $3,630.78 | Professional | None | $288.40 | $588.84 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,762.47 | Facility | None | $1,047.13 | $2,344.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $1,047.13 | Professional | None | $288.40 | $512.86 | $1,047.13 |
Well Sense Setting Facility Modifier None Typical Low $190.55 Median $281.84 Typical High $426.58 | Facility | None | $190.55 | $281.84 | $426.58 |
Well Sense Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $309.03 | Professional | None | $169.82 | $229.09 | $309.03 |
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 $120.23 Median $186.21 Typical High $316.23 | Professional | 52 · Reduced service | $120.23 | $186.21 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $74.13 Typical High $125.89 | Professional | 53 · Discontinued | $47.86 | $74.13 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $275.42 Typical High $478.63 | Professional | 54 · Surgery only | $177.83 | $275.42 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $54.95 Typical High $95.50 | Professional | 55 · Aftercare only | $35.48 | $54.95 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $37.15 Typical High $63.10 | Professional | 56 · Pre-op care only | $23.99 | $37.15 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $257.04 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $165.96 | $257.04 | $446.68 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $147.91 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $109.65 | $147.91 | $199.53 |
Where Massachusetts sits
The same service costs 3.9 times more in Wyoming 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
$525
WY $1,096UT $282
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.