How much rates vary
Facilitymedian $141 · 10th to 90th $74 to $2,239Professionalmedian $151 · 10th to 90th $87 to $363
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 $128.82 Median $2,691.53 Typical High $5,128.61 | Facility | None | $128.82 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $213.80 | Professional | None | $109.65 | $125.89 | $213.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $63.10 Median $380.19 Typical High $1,862.09 | Facility | None | $63.10 | $380.19 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $85.11 Median $199.53 Typical High $1,096.48 | Professional | None | $85.11 | $199.53 | $1,096.48 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $190.55 | Facility | None | $85.11 | $85.11 | $190.55 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $194.98 | Professional | None | $85.11 | $112.20 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $100.00 | Facility | None | $50.12 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $288.40 | Professional | None | $97.72 | $151.36 | $288.40 |
Fallon Health Setting Facility Modifier None Typical Low $81.28 Median $107.15 Typical High $3,311.31 | Facility | None | $81.28 | $107.15 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $194.98 | Professional | None | $102.33 | $128.82 | $194.98 |
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 $93.33 Median $186.21 Typical High $288.40 | Professional | None | $93.33 | $186.21 | $288.40 |
Health New England Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Health New England Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $169.82 | Professional | None | $74.13 | $74.13 | $169.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $63.10 Median $380.19 Typical High $1,862.09 | Facility | None | $63.10 | $380.19 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $85.11 Median $199.53 Typical High $1,096.48 | Professional | None | $85.11 | $199.53 | $1,096.48 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $288.40 | Professional | None | $89.13 | $134.90 | $288.40 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $91.20 Typical High $141.25 | Facility | None | $60.26 | $91.20 | $141.25 |
Well Sense Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $104.71 | Professional | None | $75.86 | $87.10 | $104.71 |
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 $54.95 Median $64.57 Typical High $141.25 | Professional | 52 · Reduced service | $54.95 | $64.57 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $25.70 Typical High $57.54 | Professional | 53 · Discontinued | $21.88 | $25.70 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $95.50 Typical High $213.80 | Professional | 54 · Surgery only | $83.18 | $95.50 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.50 Typical High $42.66 | Professional | 55 · Aftercare only | $16.60 | $19.50 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $10.96 | $12.88 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $89.13 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $77.62 | $89.13 | $199.53 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $56.23 Typical High $66.07 | Professional | 78 · Unplanned return to OR | $47.86 | $56.23 | $66.07 |
Where Massachusetts sits
The same service costs 4.2 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
$151
AK $324FL $77.62
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.