How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,259 to $20,893Professionalmedian $5,129 · 10th to 90th $3,020 to $28,184
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 $3,019.95 Median $3,019.95 Typical High $8,317.64 | Professional | None | $3,019.95 | $3,019.95 | $8,317.64 |
AllWays Health Partners Setting Facility Modifier None Typical Low $954.99 Median $7,585.78 Typical High $25,118.86 | Facility | None | $954.99 | $7,585.78 | $25,118.86 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3,090.30 Median $7,585.78 Typical High $28,183.83 | Professional | None | $3,090.30 | $7,585.78 | $28,183.83 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $18,620.87 Typical High $26,915.35 | Facility | None | $741.31 | $18,620.87 | $26,915.35 |
Cigna Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $8,317.64 | Professional | None | $4,265.80 | $4,265.80 | $8,317.64 |
Fallon Health Setting Facility Modifier None Typical Low $3,090.30 Median $3,981.07 Typical High $4,786.30 | Facility | None | $3,090.30 | $3,981.07 | $4,786.30 |
Fallon Health Setting Professional Modifier None Typical Low $3,548.13 Median $4,073.80 Typical High $4,786.30 | Professional | None | $3,548.13 | $4,073.80 | $4,786.30 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,096.48 | $4,073.80 | $14,125.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3,467.37 Median $6,456.54 Typical High $9,332.54 | Professional | None | $3,467.37 | $6,456.54 | $9,332.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $954.99 Median $7,585.78 Typical High $25,118.86 | Facility | None | $954.99 | $7,585.78 | $25,118.86 |
Mass General Brigham Setting Professional Modifier None Typical Low $3,090.30 Median $7,585.78 Typical High $28,183.83 | Professional | None | $3,090.30 | $7,585.78 | $28,183.83 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $33,884.42 | Facility | None | $1,258.93 | $4,073.80 | $33,884.42 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $5,011.87 Typical High $13,803.84 | Professional | None | $3,715.35 | $5,011.87 | $13,803.84 |
Well Sense Setting Facility Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $5,011.87 | Facility | None | $2,398.83 | $3,235.94 | $5,011.87 |
Well Sense Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,019.95 | Professional | None | $2,238.72 | $2,238.72 | $3,019.95 |
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 $1,513.56 Median $1,513.56 Typical High $4,168.69 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $1,659.59 | Professional | 53 · Discontinued | $602.56 | $602.56 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,238.72 Typical High $6,309.57 | Professional | 54 · Surgery only | $2,238.72 | $2,238.72 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $1,258.93 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $831.76 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $5,888.44 |
Where Massachusetts sits
The same service costs 20.4 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· 15th of 51
$5,012
AK $13,183TX $646
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.