How much rates vary
Facilitymedian $2,188 · 10th to 90th $776 to $7,079Professionalmedian $1,445 · 10th to 90th $891 to $8,710
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 $2,089.30 Median $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $2,511.89 | Professional | None | $831.76 | $831.76 | $2,511.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $758.58 Median $3,467.37 Typical High $9,549.93 | Facility | None | $758.58 | $3,467.37 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $891.25 Median $2,187.76 Typical High $8,709.64 | Professional | None | $891.25 | $2,187.76 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $3,890.45 Typical High $5,754.40 | Facility | None | $446.68 | $3,890.45 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,202.26 | $2,398.83 |
Fallon Health Setting Facility Modifier None Typical Low $933.25 Median $1,174.90 Typical High $3,311.31 | Facility | None | $933.25 | $1,174.90 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,202.26 | $1,380.38 |
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 $1,000.00 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,819.70 | $2,754.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $758.58 Median $3,467.37 Typical High $9,549.93 | Facility | None | $758.58 | $3,467.37 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $891.25 Median $2,187.76 Typical High $8,709.64 | Professional | None | $891.25 | $2,187.76 | $8,709.64 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $13,489.63 | Facility | None | $1,071.52 | $3,467.37 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $4,073.80 | Professional | None | $1,023.29 | $1,380.38 | $4,073.80 |
Well Sense Setting Facility Modifier None Typical Low $758.58 Median $1,348.96 Typical High $1,905.46 | Facility | None | $758.58 | $1,348.96 | $1,905.46 |
Well Sense Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
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 $416.87 Median $416.87 Typical High $1,258.93 | Professional | 52 · Reduced service | $416.87 | $416.87 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $501.19 | Professional | 53 · Discontinued | $165.96 | $165.96 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $1,905.46 | Professional | 54 · Surgery only | $616.60 | $616.60 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $380.19 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $251.19 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,778.28 |
Where Massachusetts sits
The same service costs 20.0 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
$1,479
AK $3,715TX $186
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.