How much rates vary
Facilitymedian $126 · 10th to 90th $25 to $1,122Professionalmedian $89 · 10th to 90th $34 to $295
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 $77.62 Median $1,905.46 Typical High $3,388.44 | Facility | None | $77.62 | $1,905.46 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $77.62 Typical High $169.82 | Professional | None | $22.39 | $77.62 | $169.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $50.12 Median $204.17 Typical High $1,862.09 | Facility | None | $50.12 | $204.17 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $36.31 Median $102.33 Typical High $645.65 | Professional | None | $36.31 | $102.33 | $645.65 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $33.88 Median $169.82 Typical High $239.88 | Facility | None | $33.88 | $169.82 | $239.88 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $33.88 Median $120.23 Typical High $208.93 | Professional | None | $33.88 | $120.23 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $338.84 | Facility | None | $302.00 | $302.00 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $89.13 Typical High $229.09 | Professional | None | $28.84 | $89.13 | $229.09 |
Fallon Health Setting Facility Modifier None Typical Low $19.50 Median $38.90 Typical High $83.18 | Facility | None | $19.50 | $38.90 | $83.18 |
Fallon Health Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $169.82 | Professional | None | $67.61 | $117.49 | $169.82 |
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 $37.15 Median $97.72 Typical High $281.84 | Professional | None | $37.15 | $97.72 | $281.84 |
Health New England Setting Facility Modifier None Typical Low $177.83 Median $354.81 Typical High $758.58 | Facility | None | $177.83 | $354.81 | $758.58 |
Health New England Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $50.12 Median $204.17 Typical High $1,862.09 | Facility | None | $50.12 | $204.17 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $36.31 Median $102.33 Typical High $645.65 | Professional | None | $36.31 | $102.33 | $645.65 |
Tufts Setting Facility Modifier None Typical Low $169.82 Median $338.84 Typical High $562.34 | Facility | None | $169.82 | $338.84 | $562.34 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $33.88 Median $64.57 Typical High $112.20 | Professional | None | $33.88 | $64.57 | $112.20 |
Well Sense Setting Facility Modifier None Typical Low $30.20 Median $60.26 Typical High $125.89 | Facility | None | $30.20 | $60.26 | $125.89 |
Well Sense Setting Professional Modifier None Typical Low $22.91 Median $27.54 Typical High $58.88 | Professional | None | $22.91 | $27.54 | $58.88 |
4 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 54 · Surgery only Typical Low $16.60 Median $57.54 Typical High $72.44 | Professional | 54 · Surgery only | $16.60 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $11.48 Typical High $14.79 | Professional | 55 · Aftercare only | $3.39 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $7.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $2.24 | $7.76 | $9.77 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $165.96 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $97.72 | $165.96 | $223.87 |
Where Massachusetts sits
The same service costs 2.8 times more in Alaska 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· 14th of 51
$91.20
AK $141KY $51.29
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.