How much rates vary
Facilitymedian $2,138 · 10th to 90th $631 to $4,786Professionalmedian $4,074 · 10th to 90th $2,344 to $17,378
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 $1,819.70 Median $1,819.70 Typical High $6,760.83 | Professional | None | $1,819.70 | $1,819.70 | $6,760.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $5,248.07 | Facility | None | $602.56 | $1,318.26 | $5,248.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,511.89 Median $6,309.57 Typical High $17,378.01 | Professional | None | $2,511.89 | $6,309.57 | $17,378.01 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,513.56 Typical High $2,187.76 | Facility | None | $831.76 | $1,513.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $3,019.95 Typical High $6,456.54 | Professional | None | $2,951.21 | $3,019.95 | $6,456.54 |
Fallon Health Setting Facility Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,187.76 | $3,235.94 | $3,981.07 |
Fallon Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,388.44 Typical High $3,981.07 | Professional | None | $2,951.21 | $3,388.44 | $3,981.07 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,884.03 Median $5,248.07 Typical High $7,585.78 | Professional | None | $2,884.03 | $5,248.07 | $7,585.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $5,248.07 | Facility | None | $602.56 | $1,318.26 | $5,248.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,511.89 Median $6,309.57 Typical High $17,378.01 | Professional | None | $2,511.89 | $6,309.57 | $17,378.01 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,918.31 | Facility | None | $575.44 | $1,380.38 | $6,918.31 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $3,801.89 Typical High $9,332.54 | Professional | None | $2,344.23 | $3,801.89 | $9,332.54 |
Well Sense Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $3,981.07 | Facility | None | $691.83 | $2,187.76 | $3,981.07 |
Well Sense Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,819.70 | $2,187.76 |
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 $912.01 Median $912.01 Typical High $3,388.44 | Professional | 52 · Reduced service | $912.01 | $912.01 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $1,348.96 | Professional | 53 · Discontinued | $363.08 | $363.08 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $5,128.61 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $5,128.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $1,023.29 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $676.08 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $4,786.30 |
Where Massachusetts sits
The same service costs 15.8 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· 12th of 51
$3,802
AK $8,128TX $513
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.