How much rates vary
Facilitymedian $251 · 10th to 90th $129 to $2,344Professionalmedian $309 · 10th to 90th $151 to $1,622
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 $645.65 Median $2,691.53 Typical High $3,715.35 | Facility | None | $645.65 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $398.11 | Professional | None | $120.23 | $194.98 | $398.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $134.90 Median $524.81 Typical High $1,862.09 | Facility | None | $134.90 | $524.81 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $154.88 Median $371.54 Typical High $1,621.81 | Professional | None | $154.88 | $371.54 | $1,621.81 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $331.13 | Facility | None | $147.91 | $147.91 | $331.13 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $446.68 | Professional | None | $251.19 | $251.19 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $309.03 Typical High $831.76 | Facility | None | $100.00 | $309.03 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $630.96 | Professional | None | $177.83 | $281.84 | $630.96 |
Fallon Health Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $3,311.31 | Facility | None | $131.83 | $181.97 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $398.11 | Professional | None | $269.15 | $323.59 | $398.11 |
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 $151.36 Median $323.59 Typical High $630.96 | Professional | None | $151.36 | $323.59 | $630.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $134.90 Median $524.81 Typical High $1,862.09 | Facility | None | $134.90 | $524.81 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $154.88 Median $371.54 Typical High $1,621.81 | Professional | None | $154.88 | $371.54 | $1,621.81 |
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 $158.49 Median $302.00 Typical High $660.69 | Professional | None | $158.49 | $302.00 | $660.69 |
Well Sense Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $257.04 | Facility | None | $125.89 | $169.82 | $257.04 |
Well Sense Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $194.98 | Professional | None | $102.33 | $123.03 | $194.98 |
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 $60.26 Median $97.72 Typical High $199.53 | Professional | 52 · Reduced service | $60.26 | $97.72 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $38.90 Typical High $79.43 | Professional | 53 · Discontinued | $23.99 | $38.90 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $147.91 Typical High $302.00 | Professional | 54 · Surgery only | $89.13 | $147.91 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $29.51 Typical High $60.26 | Professional | 55 · Aftercare only | $18.20 | $29.51 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $19.50 Typical High $39.81 | Professional | 56 · Pre-op care only | $12.02 | $19.50 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $138.04 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $83.18 | $138.04 | $281.84 |
Where Massachusetts sits
The same service costs 3.5 times more in Wisconsin 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· 7th of 51
$309
WI $575KY $162
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.