How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,023 to $7,244Professionalmedian $2,570 · 10th to 90th $1,549 to $16,982
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 $1,949.84 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,235.94 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $4,677.35 | Professional | None | $1,548.82 | $1,548.82 | $4,677.35 |
AllWays Health Partners Setting Facility Modifier None Typical Low $954.99 Median $3,467.37 Typical High $9,549.93 | Facility | None | $954.99 | $3,467.37 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $16,982.44 | Professional | None | $1,513.56 | $3,715.35 | $16,982.44 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,897.79 Typical High $7,413.10 | Facility | None | $741.31 | $4,897.79 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $4,265.80 | Professional | None | $2,137.96 | $2,137.96 | $4,265.80 |
Fallon Health Setting Facility Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,311.31 | Facility | None | $1,584.89 | $1,995.26 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,737.80 | $2,041.74 | $2,344.23 |
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 $1,698.24 Median $3,162.28 Typical High $4,786.30 | Professional | None | $1,698.24 | $3,162.28 | $4,786.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $954.99 Median $3,467.37 Typical High $9,549.93 | Facility | None | $954.99 | $3,467.37 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $16,982.44 | Professional | None | $1,513.56 | $3,715.35 | $16,982.44 |
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 $1,862.09 Median $2,570.40 Typical High $7,413.10 | Professional | None | $1,862.09 | $2,570.40 | $7,413.10 |
Well Sense Setting Facility Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,511.89 | Facility | None | $1,348.96 | $1,862.09 | $2,511.89 |
Well Sense Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,148.15 | $1,548.82 |
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 $776.25 Median $776.25 Typical High $2,344.23 | Professional | 52 · Reduced service | $776.25 | $776.25 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $933.25 | Professional | 53 · Discontinued | $309.03 | $309.03 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $707.95 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $467.74 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $3,311.31 |
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
$2,570
AK $6,607TX $324
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.