How much rates vary
Facilitymedian $724 · 10th to 90th $355 to $3,311Professionalmedian $871 · 10th to 90th $525 to $4,365
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 $1,778.28 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,778.28 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,479.11 | Professional | None | $501.19 | $501.19 | $1,479.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $707.95 Typical High $2,511.89 | Facility | None | $354.81 | $707.95 | $2,511.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $562.34 Median $1,318.26 Typical High $4,365.16 | Professional | None | $562.34 | $1,318.26 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $691.83 Typical High $954.99 | Facility | None | $588.84 | $691.83 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,445.44 | Professional | None | $724.44 | $724.44 | $1,445.44 |
Fallon Health Setting Facility Modifier None Typical Low $575.44 Median $741.31 Typical High $3,311.31 | Facility | None | $575.44 | $741.31 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $870.96 | Professional | None | $645.65 | $741.31 | $870.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $1,621.81 | Professional | None | $616.60 | $1,148.15 | $1,621.81 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $707.95 Typical High $2,511.89 | Facility | None | $354.81 | $707.95 | $2,511.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $562.34 Median $1,318.26 Typical High $4,365.16 | Professional | None | $562.34 | $1,318.26 | $4,365.16 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $2,454.71 | Professional | None | $602.56 | $831.76 | $2,454.71 |
Well Sense Setting Facility Modifier None Typical Low $263.03 Median $457.09 Typical High $812.83 | Facility | None | $263.03 | $457.09 | $812.83 |
Well Sense Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $512.86 | Professional | None | $380.19 | $380.19 | $512.86 |
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 $251.19 Median $251.19 Typical High $741.31 | Professional | 52 · Reduced service | $251.19 | $251.19 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $302.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $1,122.02 | Professional | 54 · Surgery only | $371.54 | $371.54 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $223.87 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $147.91 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $1,047.13 |
Where Massachusetts sits
The same service costs 6.3 times more in Alaska than in Utah. 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
$871
AK $2,239UT $355
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.