How much rates vary
Facilitymedian $2,692 · 10th to 90th $933 to $8,318Professionalmedian $3,548 · 10th to 90th $1,950 to $19,055
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 $1,862.09 Median $1,862.09 Typical High $6,456.54 | Professional | None | $1,862.09 | $1,862.09 | $6,456.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $831.76 Median $4,265.80 Typical High $14,454.40 | Facility | None | $831.76 | $4,265.80 | $14,454.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,949.84 Median $4,897.79 Typical High $19,054.61 | Professional | None | $1,949.84 | $4,897.79 | $19,054.61 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $2,238.72 | Facility | None | $741.31 | $1,479.11 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $5,370.32 | Professional | None | $2,691.53 | $2,691.53 | $5,370.32 |
Fallon Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $3,548.13 | Facility | None | $2,041.74 | $2,511.89 | $3,548.13 |
Fallon Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $3,019.95 | Professional | None | $2,238.72 | $2,630.27 | $3,019.95 |
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 $2,238.72 Median $4,073.80 Typical High $5,888.44 | Professional | None | $2,238.72 | $4,073.80 | $5,888.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $831.76 Median $4,265.80 Typical High $14,454.40 | Facility | None | $831.76 | $4,265.80 | $14,454.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,949.84 Median $4,897.79 Typical High $19,054.61 | Professional | None | $1,949.84 | $4,897.79 | $19,054.61 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $9,332.54 | Facility | None | $1,071.52 | $3,890.45 | $9,332.54 |
United Setting Professional Modifier None Typical Low $2,570.40 Median $3,467.37 Typical High $9,120.11 | Professional | None | $2,570.40 | $3,467.37 | $9,120.11 |
Well Sense Setting Facility Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $3,162.28 | Facility | None | $1,513.56 | $2,089.30 | $3,162.28 |
Well Sense Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,584.89 | $2,137.96 |
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 $933.25 Median $933.25 Typical High $3,162.28 | Professional | 52 · Reduced service | $933.25 | $933.25 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $1,288.25 | Professional | 53 · Discontinued | $371.54 | $371.54 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $4,786.30 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $954.99 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $645.65 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $4,466.84 |
Where Massachusetts sits
The same service costs 19.5 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· 13th of 51
$3,467
AK $8,318TX $427
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.