How much rates vary
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 $41.69 Median $2,818.38 Typical High $5,128.61 | Facility | None | $41.69 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $17.38 | Professional | None | $12.02 | $12.02 | $17.38 |
AllWays Health Partners Setting Facility Modifier None Typical Low $12.59 Median $30.20 Typical High $37.15 | Facility | None | $12.59 | $30.20 | $37.15 |
AllWays Health Partners Setting Professional Modifier None Typical Low $12.02 Median $30.20 Typical High $85.11 | Professional | None | $12.02 | $30.20 | $85.11 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $12.59 Median $19.05 Typical High $28.84 | Professional | None | $12.59 | $19.05 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $16.98 | Professional | None | $10.72 | $10.72 | $16.98 |
Fallon Health Setting Facility Modifier None Typical Low $12.59 Median $15.49 Typical High $83.18 | Facility | None | $12.59 | $15.49 | $83.18 |
Fallon Health Setting Professional Modifier None Typical Low $13.49 Median $16.22 Typical High $21.88 | Professional | None | $13.49 | $16.22 | $21.88 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $14.13 Median $20.89 Typical High $36.31 | Professional | None | $14.13 | $20.89 | $36.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $12.59 Median $30.20 Typical High $37.15 | Facility | None | $12.59 | $30.20 | $37.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $12.02 Median $30.20 Typical High $85.11 | Professional | None | $12.02 | $30.20 | $85.11 |
United Setting Professional Modifier None Typical Low $12.02 Median $17.78 Typical High $32.36 | Professional | None | $12.02 | $17.78 | $32.36 |
Well Sense Setting Facility Modifier None Typical Low $10.72 Median $14.79 Typical High $22.39 | Facility | None | $10.72 | $14.79 | $22.39 |
Well Sense Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.59 | Professional | None | $10.47 | $10.47 | $12.59 |
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 $6.03 Median $6.03 Typical High $8.32 | Professional | 52 · Reduced service | $6.03 | $6.03 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $3.31 | Professional | 53 · Discontinued | $2.40 | $2.40 | $3.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $8.91 Typical High $12.30 | Professional | 54 · Surgery only | $8.91 | $8.91 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $2.45 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $1.66 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $14.79 Median $17.38 Typical High $25.12 | Professional | 78 · Unplanned return to OR | $14.79 | $17.38 | $25.12 |
Where Massachusetts sits
The same service costs 3.3 times more in Alaska than in Delaware. 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· 13th of 51
$18.20
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.