How much rates vary
Facilitymedian $3,631 · 10th to 90th $912 to $8,913Professionalmedian $2,089 · 10th to 90th $1,380 to $8,710
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 $1,949.84 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,235.94 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,288.25 | $1,380.38 | $1,380.38 |
AllWays Health Partners Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $8,709.64 | Facility | None | $891.25 | $3,890.45 | $8,709.64 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,584.89 Median $3,235.94 Typical High $8,709.64 | Professional | None | $1,584.89 | $3,235.94 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $7,079.46 Typical High $9,120.11 | Facility | None | $676.08 | $7,079.46 | $9,120.11 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $1,949.84 Typical High $5,888.44 | Facility | None | $83.18 | $1,949.84 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,659.59 | $1,949.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $3,715.35 | Professional | None | $1,445.44 | $2,630.27 | $3,715.35 |
Mass General Brigham Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $8,709.64 | Facility | None | $891.25 | $3,890.45 | $8,709.64 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,584.89 Median $3,235.94 Typical High $8,709.64 | Professional | None | $1,584.89 | $3,235.94 | $8,709.64 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,595.87 | Facility | None | $1,071.52 | $3,890.45 | $16,595.87 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $5,370.32 | Professional | None | $1,412.54 | $1,862.09 | $5,370.32 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $4,897.79 | Facility | None | $2,511.89 | $3,630.78 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,388.44 | Professional | None | $2,511.89 | $2,511.89 | $3,388.44 |
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 $645.65 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $645.65 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $257.04 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $954.99 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $190.55 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $128.82 | $138.04 | $138.04 |
Where Massachusetts sits
The same service costs 5.9 times more in Texas 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· 11th of 51
$2,344
TX $5,754KY $977
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.