How much rates vary
Facilitymedian $2,570 · 10th to 90th $813 to $7,413Professionalmedian $1,995 · 10th to 90th $1,175 to $10,000
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 $3,388.44 Typical High $6,309.57 | Facility | None | $2,691.53 | $3,388.44 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $3,388.44 | Professional | None | $1,047.13 | $1,047.13 | $3,388.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $645.65 Median $3,467.37 Typical High $10,232.93 | Facility | None | $645.65 | $3,467.37 | $10,232.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,230.27 Median $3,019.95 Typical High $10,000.00 | Professional | None | $1,230.27 | $3,019.95 | $10,000.00 |
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 $1,698.24 Median $1,698.24 Typical High $3,311.31 | Professional | None | $1,698.24 | $1,698.24 | $3,311.31 |
Fallon Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $3,311.31 | Facility | None | $1,148.15 | $1,584.89 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,621.81 | $1,905.46 |
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 $1,380.38 Median $2,511.89 Typical High $3,715.35 | Professional | None | $1,380.38 | $2,511.89 | $3,715.35 |
Mass General Brigham Setting Facility Modifier None Typical Low $645.65 Median $3,467.37 Typical High $10,232.93 | Facility | None | $645.65 | $3,467.37 | $10,232.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,230.27 Median $3,019.95 Typical High $10,000.00 | Professional | None | $1,230.27 | $3,019.95 | $10,000.00 |
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 $1,380.38 Median $1,949.84 Typical High $5,754.40 | Professional | None | $1,380.38 | $1,949.84 | $5,754.40 |
Well Sense Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,949.84 | Facility | None | $954.99 | $1,318.26 | $1,949.84 |
Well Sense Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,202.26 | Professional | None | $891.25 | $891.25 | $1,202.26 |
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 $524.81 Median $524.81 Typical High $1,698.24 | Professional | 52 · Reduced service | $524.81 | $524.81 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $676.08 | Professional | 53 · Discontinued | $213.80 | $213.80 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $2,570.40 | Professional | 54 · Surgery only | $794.33 | $794.33 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $512.86 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $338.84 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $2,398.83 |
Where Massachusetts sits
The same service costs 17.8 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
$2,042
AK $5,129TX $288
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.