How much rates vary
Facilitymedian $2,188 · 10th to 90th $794 to $5,754Professionalmedian $2,951 · 10th to 90th $1,479 to $11,749
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 $1,202.26 Median $1,202.26 Typical High $4,365.16 | Professional | None | $1,202.26 | $1,202.26 | $4,365.16 |
AllWays Health Partners Setting Facility Modifier None Typical Low $630.96 Median $2,187.76 Typical High $5,888.44 | Facility | None | $630.96 | $2,187.76 | $5,888.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,659.59 Median $4,265.80 Typical High $11,748.98 | Professional | None | $1,659.59 | $4,265.80 | $11,748.98 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,570.40 Typical High $3,715.35 | Facility | None | $831.76 | $2,570.40 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $4,265.80 | Professional | None | $1,949.84 | $2,041.74 | $4,265.80 |
Fallon Health Setting Facility Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $3,311.31 | Facility | None | $1,584.89 | $2,187.76 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,290.87 | $2,691.53 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,905.46 Median $3,548.13 Typical High $5,248.07 | Professional | None | $1,905.46 | $3,548.13 | $5,248.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $630.96 Median $2,187.76 Typical High $5,888.44 | Facility | None | $630.96 | $2,187.76 | $5,888.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,659.59 Median $4,265.80 Typical High $11,748.98 | Professional | None | $1,659.59 | $4,265.80 | $11,748.98 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,454.71 Typical High $6,165.95 | Professional | None | $1,479.11 | $2,454.71 | $6,165.95 |
Well Sense Setting Facility Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,630.27 | Facility | None | $1,122.02 | $1,548.82 | $2,630.27 |
Well Sense Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,202.26 | $1,412.54 |
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 $602.56 Median $602.56 Typical High $2,137.96 | Professional | 52 · Reduced service | $602.56 | $602.56 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $870.96 | Professional | 53 · Discontinued | $239.88 | $239.88 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $3,235.94 | Professional | 54 · Surgery only | $891.25 | $891.25 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $645.65 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $436.52 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $3,019.95 |
Where Massachusetts sits
The same service costs 8.7 times more in Alaska than in Texas. 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
$2,630
AK $7,244TX $832
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.