How much rates vary
Facilitymedian $2,089 · 10th to 90th $603 to $6,918Professionalmedian $977 · 10th to 90th $589 to $5,370
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 $562.34 Median $562.34 Typical High $1,698.24 | Professional | None | $562.34 | $562.34 | $1,698.24 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $2,398.83 Typical High $9,549.93 | Facility | None | $549.54 | $2,398.83 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $645.65 Median $1,479.11 Typical High $5,370.32 | Professional | None | $645.65 | $1,479.11 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,677.35 Typical High $7,079.46 | Facility | None | $676.08 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,621.81 | Professional | None | $812.83 | $812.83 | $1,621.81 |
Fallon Health Setting Facility Modifier None Typical Low $630.96 Median $812.83 Typical High $3,311.31 | Facility | None | $630.96 | $812.83 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $977.24 | Professional | None | $724.44 | $831.76 | $977.24 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $691.83 Median $1,288.25 Typical High $1,905.46 | Professional | None | $691.83 | $1,288.25 | $1,905.46 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $2,398.83 Typical High $9,549.93 | Facility | None | $549.54 | $2,398.83 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $645.65 Median $1,479.11 Typical High $5,370.32 | Professional | None | $645.65 | $1,479.11 | $5,370.32 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $12,302.69 | Facility | None | $851.14 | $2,818.38 | $12,302.69 |
United Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $2,691.53 | Professional | None | $691.83 | $933.25 | $2,691.53 |
Well Sense Setting Facility Modifier None Typical Low $512.86 Median $724.44 Typical High $2,398.83 | Facility | None | $512.86 | $724.44 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $575.44 | Professional | None | $426.58 | $426.58 | $575.44 |
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 $275.42 Median $275.42 Typical High $831.76 | Professional | 52 · Reduced service | $275.42 | $275.42 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $338.84 | Professional | 53 · Discontinued | $112.20 | $112.20 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $1,258.93 | Professional | 54 · Surgery only | $416.87 | $416.87 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $251.19 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $169.82 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $1,174.90 |
Where Massachusetts sits
The same service costs 8.1 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
$977
AK $2,512TX $309
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.