How much rates vary
Facilitymedian $174 · 10th to 90th $74 to $661Professionalmedian $186 · 10th to 90th $105 to $3,162
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 $316.23 Typical High $380.19 | Facility | None | $128.82 | $316.23 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | None | $128.82 | $128.82 | $151.36 |
AllWays Health Partners Setting Facility Modifier None Typical Low $302.00 Median $389.05 Typical High $724.44 | Facility | None | $302.00 | $389.05 | $724.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $120.23 Median $323.59 Typical High $3,162.28 | Professional | None | $120.23 | $323.59 | $3,162.28 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $446.68 Median $524.81 Typical High $691.83 | Facility | None | $446.68 | $524.81 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $380.19 Typical High $724.44 | Facility | None | $141.25 | $380.19 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $288.40 | Professional | None | $138.04 | $181.97 | $288.40 |
Fallon Health Setting Facility Modifier None Typical Low $67.61 Median $123.03 Typical High $190.55 | Facility | None | $67.61 | $123.03 | $190.55 |
Fallon Health Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $190.55 | Professional | None | $70.79 | $123.03 | $190.55 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $123.03 Median $251.19 Typical High $354.81 | Professional | None | $123.03 | $251.19 | $354.81 |
Mass General Brigham Setting Facility Modifier None Typical Low $302.00 Median $389.05 Typical High $724.44 | Facility | None | $302.00 | $389.05 | $724.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $120.23 Median $323.59 Typical High $3,162.28 | Professional | None | $120.23 | $323.59 | $3,162.28 |
United Setting Facility Modifier None Typical Low $457.09 Median $870.96 Typical High $1,288.25 | Facility | None | $457.09 | $870.96 | $1,288.25 |
United Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $354.81 | Professional | None | $109.65 | $147.91 | $354.81 |
Well Sense Setting Facility Modifier None Typical Low $81.28 Median $112.20 Typical High $165.96 | Facility | None | $81.28 | $112.20 | $165.96 |
Well Sense Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $117.49 | Professional | None | $87.10 | $87.10 | $117.49 |
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 $64.57 Median $64.57 Typical High $75.86 | Professional | 52 · Reduced service | $64.57 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $25.70 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $15.14 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $66.07 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $54.95 | $66.07 | $74.13 |
Where Massachusetts sits
The same service costs 3.0 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· 9th of 51
$186
AK $275FL $91.20
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.