How much rates vary
Facilitymedian $87 · 10th to 90th $45 to $1,862Professionalmedian $98 · 10th to 90th $50 to $1,905
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 $61.66 Median $2,691.53 Typical High $5,128.61 | Facility | None | $61.66 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $138.04 | Professional | None | $50.12 | $61.66 | $138.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $354.81 Typical High $1,862.09 | Facility | None | $50.12 | $354.81 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $54.95 Median $112.20 Typical High $1,905.46 | Professional | None | $54.95 | $112.20 | $1,905.46 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $102.33 | Facility | None | $44.67 | $44.67 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $61.66 Typical High $100.00 | Facility | None | $44.67 | $61.66 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $95.50 Typical High $165.96 | Professional | None | $45.71 | $95.50 | $165.96 |
Fallon Health Setting Facility Modifier None Typical Low $46.77 Median $58.88 Typical High $3,311.31 | Facility | None | $46.77 | $58.88 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $125.89 | Professional | None | $75.86 | $93.33 | $125.89 |
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 $57.54 Median $104.71 Typical High $181.97 | Professional | None | $57.54 | $104.71 | $181.97 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $354.81 Typical High $1,862.09 | Facility | None | $50.12 | $354.81 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $54.95 Median $112.20 Typical High $1,905.46 | Professional | None | $54.95 | $112.20 | $1,905.46 |
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 $57.54 Median $85.11 Typical High $186.21 | Professional | None | $57.54 | $85.11 | $186.21 |
Well Sense Setting Facility Modifier None Typical Low $26.92 Median $51.29 Typical High $81.28 | Facility | None | $26.92 | $51.29 | $81.28 |
Well Sense Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $54.95 | Professional | None | $37.15 | $45.71 | $54.95 |
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 $25.12 Median $30.90 Typical High $69.18 | Professional | 52 · Reduced service | $25.12 | $30.90 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.59 Typical High $27.54 | Professional | 53 · Discontinued | $10.00 | $12.59 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $46.77 Typical High $104.71 | Professional | 54 · Surgery only | $37.15 | $46.77 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $9.33 Typical High $20.89 | Professional | 55 · Aftercare only | $7.59 | $9.33 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.31 Typical High $13.80 | Professional | 56 · Pre-op care only | $5.01 | $6.31 | $13.80 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $23.99 Median $29.51 Typical High $35.48 | Professional | 78 · Unplanned return to OR | $23.99 | $29.51 | $35.48 |
Where Massachusetts sits
The same service costs 3.7 times more in Alaska 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.
Massachusetts· 10th of 51
$97.72
AK $191FL $51.29
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.