How much rates vary
Facilitymedian $2,455 · 10th to 90th $776 to $5,888Professionalmedian $3,236 · 10th to 90th $1,622 to $26,915
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 $2,691.53 Median $3,090.30 Typical High $5,623.41 | Facility | None | $2,691.53 | $3,090.30 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $5,623.41 | Professional | None | $1,513.56 | $1,513.56 | $5,623.41 |
AllWays Health Partners Setting Facility Modifier None Typical Low $489.78 Median $2,454.71 Typical High $6,309.57 | Facility | None | $489.78 | $2,454.71 | $6,309.57 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,862.09 Median $5,370.32 Typical High $26,915.35 | Professional | None | $1,862.09 | $5,370.32 | $26,915.35 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $1,380.38 | Facility | None | $50.12 | $954.99 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $6,456.54 | Professional | None | $3,235.94 | $3,235.94 | $6,456.54 |
Fallon Health Setting Facility Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $3,388.44 | Facility | None | $1,949.84 | $2,398.83 | $3,388.44 |
Fallon Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $3,019.95 | Professional | None | $2,089.30 | $2,454.71 | $3,019.95 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,137.96 Median $3,890.45 Typical High $5,888.44 | Professional | None | $2,137.96 | $3,890.45 | $5,888.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $489.78 Median $2,454.71 Typical High $6,309.57 | Facility | None | $489.78 | $2,454.71 | $6,309.57 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,862.09 Median $5,370.32 Typical High $26,915.35 | Professional | None | $1,862.09 | $5,370.32 | $26,915.35 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,019.95 Typical High $10,000.00 | Facility | None | $1,071.52 | $3,019.95 | $10,000.00 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $6,918.31 | Professional | None | $2,187.76 | $3,019.95 | $6,918.31 |
Well Sense Setting Facility Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $3,090.30 | Facility | None | $1,513.56 | $2,089.30 | $3,090.30 |
Well Sense Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,479.11 | $1,737.80 |
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 $758.58 Median $758.58 Typical High $2,818.38 | Professional | 52 · Reduced service | $758.58 | $758.58 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $1,122.02 | Professional | 53 · Discontinued | $302.00 | $302.00 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $4,265.80 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $851.14 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $562.34 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $3,981.07 |
Where Massachusetts sits
The same service costs 8.5 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
$3,162
AK $8,128TX $955
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.