How much rates vary
Facilitymedian $1,950 · 10th to 90th $759 to $5,888Professionalmedian $1,622 · 10th to 90th $977 to $7,413
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 $3,019.95 Typical High $4,677.35 | Facility | None | $2,089.30 | $3,019.95 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $3,019.95 | Professional | None | $933.25 | $933.25 | $3,019.95 |
AllWays Health Partners Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $6,309.57 | Facility | None | $588.84 | $2,344.23 | $6,309.57 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,148.15 Median $2,454.71 Typical High $7,413.10 | Professional | None | $1,148.15 | $2,454.71 | $7,413.10 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,187.76 Typical High $3,162.28 | Facility | None | $676.08 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,348.96 | $2,691.53 |
Fallon Health Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,348.96 | $1,584.89 |
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 $1,148.15 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,148.15 | $2,089.30 | $3,162.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $6,309.57 | Facility | None | $588.84 | $2,344.23 | $6,309.57 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,148.15 Median $2,454.71 Typical High $7,413.10 | Professional | None | $1,148.15 | $2,454.71 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $10,715.19 | Facility | None | $1,071.52 | $3,467.37 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $4,466.84 | Professional | None | $1,230.27 | $1,621.81 | $4,466.84 |
Well Sense Setting Facility Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,584.89 | Facility | None | $831.76 | $1,096.48 | $1,584.89 |
Well Sense Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,000.00 | Professional | None | $741.31 | $741.31 | $1,000.00 |
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 $457.09 Median $457.09 Typical High $1,513.56 | Professional | 52 · Reduced service | $457.09 | $457.09 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $602.56 | Professional | 53 · Discontinued | $186.21 | $186.21 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $2,238.72 | Professional | 54 · Surgery only | $691.83 | $691.83 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $446.68 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $302.00 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $2,089.30 |
Where Massachusetts sits
The same service costs 8.9 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· 18th of 51
$1,622
AK $4,169TX $468
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.