How much rates vary
Facilitymedian $138 · 10th to 90th $56 to $2,884Professionalmedian $468 · 10th to 90th $91 to $4,677
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 $251.19 Median $2,691.53 Typical High $5,128.61 | Facility | None | $251.19 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $208.93 Typical High $257.04 | Professional | None | $87.10 | $208.93 | $257.04 |
AllWays Health Partners Setting Facility Modifier None Typical Low $194.98 Median $1,819.70 Typical High $4,365.16 | Facility | None | $194.98 | $1,819.70 | $4,365.16 |
AllWays Health Partners Setting Professional Modifier None Typical Low $107.15 Median $851.14 Typical High $4,677.35 | Professional | None | $107.15 | $851.14 | $4,677.35 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $85.11 Median $218.78 Typical High $309.03 | Facility | None | $85.11 | $218.78 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $275.42 | Facility | None | $107.15 | $107.15 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $338.84 Typical High $1,659.59 | Professional | None | $114.82 | $338.84 | $1,659.59 |
Fallon Health Setting Facility Modifier None Typical Low $47.86 Median $91.20 Typical High $123.03 | Facility | None | $47.86 | $91.20 | $123.03 |
Fallon Health Setting Professional Modifier None Typical Low $489.78 Median $831.76 Typical High $1,202.26 | Professional | None | $489.78 | $831.76 | $1,202.26 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,023.29 Median $3,388.44 Typical High $5,888.44 | Facility | None | $1,023.29 | $3,388.44 | $5,888.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $91.20 Median $295.12 Typical High $1,905.46 | Professional | None | $91.20 | $295.12 | $1,905.46 |
Mass General Brigham Setting Facility Modifier None Typical Low $194.98 Median $1,819.70 Typical High $4,365.16 | Facility | None | $194.98 | $1,819.70 | $4,365.16 |
Mass General Brigham Setting Professional Modifier None Typical Low $107.15 Median $851.14 Typical High $4,677.35 | Professional | None | $107.15 | $851.14 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,388.44 Typical High $5,888.44 | Facility | None | $1,023.29 | $3,388.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $104.71 Median $275.42 Typical High $2,041.74 | Professional | None | $104.71 | $275.42 | $2,041.74 |
Well Sense Setting Facility Modifier None Typical Low $79.43 Median $154.88 Typical High $933.25 | Facility | None | $79.43 | $154.88 | $933.25 |
Well Sense Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $173.78 | Professional | None | $63.10 | $75.86 | $173.78 |
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 $43.65 Median $102.33 Typical High $125.89 | Professional | 52 · Reduced service | $43.65 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $42.66 Typical High $51.29 | Professional | 53 · Discontinued | $17.38 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $154.88 Typical High $190.55 | Professional | 54 · Surgery only | $64.57 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $30.90 Typical High $38.02 | Professional | 55 · Aftercare only | $12.88 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $8.71 | $20.89 | $25.70 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $40.74 Median $60.26 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $40.74 | $60.26 | $117.49 |
Where Massachusetts sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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· 14th of 51
$372
WA $933DC $97.72
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.