How much rates vary
Facilitymedian $1,905 · 10th to 90th $759 to $8,318Professionalmedian $1,122 · 10th to 90th $692 to $5,012
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 $1,862.09 Median $2,818.38 Typical High $5,128.61 | Facility | None | $1,862.09 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,862.09 | Professional | None | $630.96 | $630.96 | $1,862.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $812.83 Median $3,890.45 Typical High $14,454.40 | Facility | None | $812.83 | $3,890.45 | $14,454.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $758.58 Median $1,737.80 Typical High $5,011.87 | Professional | None | $758.58 | $1,737.80 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,187.76 Typical High $3,162.28 | Facility | None | $741.31 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,905.46 | Professional | None | $954.99 | $954.99 | $1,905.46 |
Fallon Health Setting Facility Modifier None Typical Low $758.58 Median $977.24 Typical High $3,311.31 | Facility | None | $758.58 | $977.24 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,148.15 | Professional | None | $870.96 | $1,000.00 | $1,148.15 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $831.76 Median $1,513.56 Typical High $2,137.96 | Professional | None | $831.76 | $1,513.56 | $2,137.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $812.83 Median $3,890.45 Typical High $14,454.40 | Facility | None | $812.83 | $3,890.45 | $14,454.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $758.58 Median $1,737.80 Typical High $5,011.87 | Professional | None | $758.58 | $1,737.80 | $5,011.87 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $12,022.64 | Facility | None | $1,071.52 | $3,890.45 | $12,022.64 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $3,162.28 | Professional | None | $794.33 | $1,096.48 | $3,162.28 |
Well Sense Setting Facility Modifier None Typical Low $549.54 Median $758.58 Typical High $1,122.02 | Facility | None | $549.54 | $758.58 | $1,122.02 |
Well Sense Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $645.65 | Professional | None | $478.63 | $478.63 | $645.65 |
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 $316.23 Median $316.23 Typical High $933.25 | Professional | 52 · Reduced service | $316.23 | $316.23 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $380.19 | Professional | 53 · Discontinued | $125.89 | $125.89 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $1,412.54 | Professional | 54 · Surgery only | $467.74 | $467.74 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $281.84 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $186.21 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $1,318.26 |
Where Massachusetts sits
The same service costs 19.5 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· 17th of 51
$1,148
AK $2,951TX $151
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.