How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,072 to $7,762Professionalmedian $4,365 · 10th to 90th $2,570 to $33,113
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 $7,943.28 | Professional | None | $2,398.83 | $2,398.83 | $7,943.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $11,748.98 | Facility | None | $758.58 | $3,715.35 | $11,748.98 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,570.40 Median $6,309.57 Typical High $33,113.11 | Professional | None | $2,570.40 | $6,309.57 | $33,113.11 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,128.61 Typical High $7,413.10 | Facility | None | $741.31 | $5,128.61 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $7,244.36 | Professional | None | $3,630.78 | $3,630.78 | $7,244.36 |
Fallon Health Setting Facility Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,630.27 | $3,235.94 | $3,981.07 |
Fallon Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,388.44 Typical High $3,890.45 | Professional | None | $2,951.21 | $3,388.44 | $3,890.45 |
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 $2,884.03 Median $5,248.07 Typical High $7,943.28 | Professional | None | $2,884.03 | $5,248.07 | $7,943.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $11,748.98 | Facility | None | $758.58 | $3,715.35 | $11,748.98 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,570.40 Median $6,309.57 Typical High $33,113.11 | Professional | None | $2,570.40 | $6,309.57 | $33,113.11 |
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 $3,162.28 Median $4,365.16 Typical High $12,022.64 | Professional | None | $3,162.28 | $4,365.16 | $12,022.64 |
Well Sense Setting Facility Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $4,265.80 | Facility | None | $2,089.30 | $2,884.03 | $4,265.80 |
Well Sense Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,995.26 | $1,995.26 | $2,691.53 |
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 $3,981.07 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $1,621.81 | Professional | 53 · Discontinued | $489.78 | $489.78 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $6,025.60 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $1,202.26 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $794.33 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $5,623.41 |
Where Massachusetts sits
The same service costs 20.9 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
$4,266
AK $11,220TX $537
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.