How much rates vary
Facilitymedian $2,630 · 10th to 90th $871 to $8,318Professionalmedian $3,236 · 10th to 90th $1,778 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 $1,698.24 Median $1,698.24 Typical High $5,754.40 | Professional | None | $1,698.24 | $1,698.24 | $5,754.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $741.31 Median $4,073.80 Typical High $14,454.40 | Facility | None | $741.31 | $4,073.80 | $14,454.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,778.28 Median $4,365.16 Typical High $19,054.61 | Professional | None | $1,778.28 | $4,365.16 | $19,054.61 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,380.38 Typical High $1,737.80 | Facility | None | $741.31 | $1,380.38 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $4,677.35 | Professional | None | $2,398.83 | $2,398.83 | $4,677.35 |
Fallon Health Setting Facility Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $3,311.31 | Facility | None | $1,819.70 | $2,238.72 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,344.23 Typical High $2,691.53 | Professional | None | $2,041.74 | $2,344.23 | $2,691.53 |
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 $1,995.26 Median $3,715.35 Typical High $5,248.07 | Professional | None | $1,995.26 | $3,715.35 | $5,248.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $741.31 Median $4,073.80 Typical High $14,454.40 | Facility | None | $741.31 | $4,073.80 | $14,454.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,778.28 Median $4,365.16 Typical High $19,054.61 | Professional | None | $1,778.28 | $4,365.16 | $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 $2,238.72 Median $3,090.30 Typical High $8,128.31 | Professional | None | $2,238.72 | $3,090.30 | $8,128.31 |
Well Sense Setting Facility Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $2,754.23 | Facility | None | $1,348.96 | $1,819.70 | $2,754.23 |
Well Sense Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,412.54 | $1,905.46 |
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 $851.14 Median $851.14 Typical High $2,818.38 | Professional | 52 · Reduced service | $851.14 | $851.14 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $1,148.15 | Professional | 53 · Discontinued | $338.84 | $338.84 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $4,265.80 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $851.14 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $575.44 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $3,981.07 |
Where Massachusetts sits
The same service costs 18.6 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
$3,090
AK $7,413TX $398
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.