How much rates vary
Facilitymedian $302 · 10th to 90th $115 to $2,512Professionalmedian $269 · 10th to 90th $132 to $1,413
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 $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $208.93 | Professional | None | $102.33 | $165.96 | $208.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $177.83 Median $707.95 Typical High $2,089.30 | Facility | None | $177.83 | $707.95 | $2,089.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $138.04 Median $331.13 Typical High $1,412.54 | Professional | None | $138.04 | $331.13 | $1,412.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $309.03 | Facility | None | $134.90 | $134.90 | $309.03 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $524.81 | Professional | None | $134.90 | $251.19 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $181.97 Typical High $263.03 | Facility | None | $53.70 | $181.97 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $537.03 | Professional | None | $162.18 | $245.47 | $537.03 |
Fallon Health Setting Facility Modifier None Typical Low $123.03 Median $169.82 Typical High $3,311.31 | Facility | None | $123.03 | $169.82 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $346.74 | Professional | None | $234.42 | $281.84 | $346.74 |
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 $141.25 Median $295.12 Typical High $549.54 | Professional | None | $141.25 | $295.12 | $549.54 |
Health New England Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $177.83 Median $707.95 Typical High $2,089.30 | Facility | None | $177.83 | $707.95 | $2,089.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $138.04 Median $331.13 Typical High $1,412.54 | Professional | None | $138.04 | $331.13 | $1,412.54 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $138.04 Median $263.03 Typical High $562.34 | Professional | None | $138.04 | $263.03 | $562.34 |
Well Sense Setting Facility Modifier None Typical Low $104.71 Median $144.54 Typical High $223.87 | Facility | None | $104.71 | $144.54 | $223.87 |
Well Sense Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $158.49 | Professional | None | $85.11 | $102.33 | $158.49 |
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 $51.29 Median $81.28 Typical High $83.18 | Professional | 52 · Reduced service | $51.29 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $32.36 Typical High $33.11 | Professional | 53 · Discontinued | $20.42 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $123.03 Typical High $123.03 | Professional | 54 · Surgery only | $77.62 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $24.55 Typical High $25.12 | Professional | 55 · Aftercare only | $15.49 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $16.22 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.23 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $114.82 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $72.44 | $114.82 | $114.82 |
Where Massachusetts sits
The same service costs 4.1 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· 8th of 51
$275
AK $513KY $126
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.