How much rates vary
Facilitymedian $81 · 10th to 90th $52 to $214Professionalmedian $135 · 10th to 90th $76 to $490
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 $120.23 Median $309.03 Typical High $380.19 | Facility | None | $120.23 | $309.03 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $109.65 | Professional | None | $97.72 | $97.72 | $109.65 |
AllWays Health Partners Setting Facility Modifier None Typical Low $81.28 Median $204.17 Typical High $275.42 | Facility | None | $81.28 | $204.17 | $275.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $89.13 Median $229.09 Typical High $489.78 | Professional | None | $89.13 | $229.09 | $489.78 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $58.88 Median $69.18 Typical High $91.20 | Facility | None | $58.88 | $69.18 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $109.65 Typical High $380.19 | Facility | None | $43.65 | $109.65 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $204.17 | Professional | None | $97.72 | $128.82 | $204.17 |
Fallon Health Setting Facility Modifier None Typical Low $51.29 Median $89.13 Typical High $125.89 | Facility | None | $51.29 | $89.13 | $125.89 |
Fallon Health Setting Professional Modifier None Typical Low $51.29 Median $87.10 Typical High $138.04 | Professional | None | $51.29 | $87.10 | $138.04 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $91.20 Median $177.83 Typical High $251.19 | Professional | None | $91.20 | $177.83 | $251.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $81.28 Median $204.17 Typical High $275.42 | Facility | None | $81.28 | $204.17 | $275.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $89.13 Median $229.09 Typical High $489.78 | Professional | None | $89.13 | $229.09 | $489.78 |
United Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $186.21 | Facility | None | $66.07 | $123.03 | $186.21 |
United Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $269.15 | Professional | None | $81.28 | $112.20 | $269.15 |
Well Sense Setting Facility Modifier None Typical Low $57.54 Median $79.43 Typical High $117.49 | Facility | None | $57.54 | $79.43 | $117.49 |
Well Sense Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $85.11 | Professional | None | $63.10 | $63.10 | $85.11 |
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 $47.86 Median $47.86 Typical High $54.95 | Professional | 52 · Reduced service | $47.86 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $22.39 | Professional | 53 · Discontinued | $19.50 | $19.50 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $16.60 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $10.96 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $10.96 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $40.74 Median $48.98 Typical High $54.95 | Professional | 78 · Unplanned return to OR | $40.74 | $48.98 | $54.95 |
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· 10th of 51
$132
AK $195FL $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.