How much rates vary
Facilitymedian $3,548 · 10th to 90th $912 to $8,913Professionalmedian $4,074 · 10th to 90th $2,512 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 $2,398.83 Median $3,235.94 Typical High $5,248.07 | Facility | None | $2,398.83 | $3,235.94 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $7,413.10 | Professional | None | $2,398.83 | $2,398.83 | $7,413.10 |
AllWays Health Partners Setting Facility Modifier None Typical Low $645.65 Median $4,265.80 Typical High $13,182.57 | Facility | None | $645.65 | $4,265.80 | $13,182.57 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,511.89 Median $6,165.95 Typical High $17,378.01 | Professional | None | $2,511.89 | $6,165.95 | $17,378.01 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,309.57 Typical High $9,120.11 | Facility | None | $741.31 | $6,309.57 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $6,760.83 | Professional | None | $3,467.37 | $3,467.37 | $6,760.83 |
Fallon Health Setting Facility Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $3,890.45 | Facility | None | $2,187.76 | $3,235.94 | $3,890.45 |
Fallon Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,311.31 Typical High $3,890.45 | Professional | None | $2,884.03 | $3,311.31 | $3,890.45 |
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 $2,818.38 Median $5,248.07 Typical High $7,585.78 | Professional | None | $2,818.38 | $5,248.07 | $7,585.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $645.65 Median $4,265.80 Typical High $13,182.57 | Facility | None | $645.65 | $4,265.80 | $13,182.57 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,511.89 Median $6,165.95 Typical High $17,378.01 | Professional | None | $2,511.89 | $6,165.95 | $17,378.01 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,595.87 | Facility | None | $1,071.52 | $3,890.45 | $16,595.87 |
United Setting Professional Modifier None Typical Low $3,019.95 Median $4,073.80 Typical High $11,220.18 | Professional | None | $3,019.95 | $4,073.80 | $11,220.18 |
Well Sense Setting Facility Modifier None Typical Low $1,949.84 Median $2,691.53 Typical High $3,981.07 | Facility | None | $1,949.84 | $2,691.53 | $3,981.07 |
Well Sense Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,905.46 | $1,905.46 | $2,570.40 |
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 $1,202.26 Median $1,202.26 Typical High $3,715.35 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $1,479.11 | Professional | 53 · Discontinued | $478.63 | $478.63 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $5,623.41 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $1,122.02 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $741.31 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $741.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $5,248.07 |
Where Massachusetts sits
The same service costs 8.7 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· 14th of 51
$4,074
AK $10,715TX $1,230
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.