How much rates vary
Facilitymedian $126 · 10th to 90th $59 to $295Professionalmedian $100 · 10th to 90th $66 to $234
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 $37.15 Median $87.10 Typical High $295.12 | Facility | None | $37.15 | $87.10 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $114.82 | Professional | None | $83.18 | $83.18 | $114.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $91.20 Median $223.87 Typical High $323.59 | Facility | None | $91.20 | $223.87 | $323.59 |
AllWays Health Partners Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $251.19 | Professional | None | $67.61 | $100.00 | $251.19 |
BCBS Setting Facility Modifier None Typical Low $199.53 Median $229.09 Typical High $309.03 | Facility | None | $199.53 | $229.09 | $309.03 |
BCBS Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $89.13 Typical High $346.74 | Facility | None | $38.02 | $89.13 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $245.47 | Professional | None | $91.20 | $128.82 | $245.47 |
Fallon Health Setting Facility Modifier None Typical Low $56.23 Median $100.00 Typical High $138.04 | Facility | None | $56.23 | $100.00 | $138.04 |
Fallon Health Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $138.04 | Professional | None | $53.70 | $85.11 | $138.04 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $234.42 | Professional | None | $87.10 | $102.33 | $234.42 |
Health New England Setting Facility Modifier None Typical Low $138.04 Median $154.88 Typical High $269.15 | Facility | None | $138.04 | $154.88 | $269.15 |
Health New England Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $91.20 Median $223.87 Typical High $323.59 | Facility | None | $91.20 | $223.87 | $323.59 |
Mass General Brigham Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $251.19 | Professional | None | $67.61 | $100.00 | $251.19 |
Tufts Setting Facility Modifier None Typical Low $93.33 Median $199.53 Typical High $457.09 | Facility | None | $93.33 | $199.53 | $457.09 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $93.33 | Facility | None | $85.11 | $85.11 | $93.33 |
United Setting Professional Modifier None Typical Low $38.02 Median $117.49 Typical High $316.23 | Professional | None | $38.02 | $117.49 | $316.23 |
Well Sense Setting Facility Modifier None Typical Low $64.57 Median $89.13 Typical High $131.83 | Facility | None | $64.57 | $89.13 | $131.83 |
Well Sense Setting Professional Modifier None Typical Low $43.65 Median $77.62 Typical High $77.62 | Professional | None | $43.65 | $77.62 | $77.62 |
5 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 $41.69 Median $41.69 Typical High $47.86 | Professional | 52 · Reduced service | $41.69 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $19.50 | Professional | 53 · Discontinued | $16.60 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $14.45 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $9.55 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $27.54 Median $34.67 Typical High $61.66 | Professional | 78 · Unplanned return to OR | $27.54 | $34.67 | $61.66 |
Where Massachusetts sits
The same service costs 2.9 times more in Alaska than in Indiana. 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· 19th of 51
$100
AK $186IN $64.57
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.