How much rates vary
Facilitymedian $1,259 · 10th to 90th $575 to $4,677Professionalmedian $1,318 · 10th to 90th $794 to $5,888
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $2,041.74 | Professional | None | $691.83 | $691.83 | $2,041.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $1,737.80 Typical High $5,623.41 | Facility | None | $457.09 | $1,737.80 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $831.76 Median $2,041.74 Typical High $5,888.44 | Professional | None | $831.76 | $2,041.74 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,162.28 | Facility | None | $588.84 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,096.48 | $2,187.76 |
Fallon Health Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $3,311.31 | Facility | None | $812.83 | $1,122.02 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,174.90 | $1,348.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $954.99 Median $1,737.80 Typical High $2,630.27 | Professional | None | $954.99 | $1,737.80 | $2,630.27 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $1,737.80 Typical High $5,623.41 | Facility | None | $457.09 | $1,737.80 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $831.76 Median $2,041.74 Typical High $5,888.44 | Professional | None | $831.76 | $2,041.74 | $5,888.44 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $8,709.64 | Facility | None | $575.44 | $1,380.38 | $8,709.64 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $3,548.13 | Professional | None | $870.96 | $1,230.27 | $3,548.13 |
Well Sense Setting Facility Modifier None Typical Low $537.03 Median $933.25 Typical High $1,380.38 | Facility | None | $537.03 | $933.25 | $1,380.38 |
Well Sense Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $707.95 | Professional | None | $524.81 | $524.81 | $707.95 |
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 $346.74 Median $346.74 Typical High $1,023.29 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $407.38 | Professional | 53 · Discontinued | $138.04 | $138.04 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $1,548.82 | Professional | 54 · Surgery only | $524.81 | $524.81 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $309.03 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $204.17 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,445.44 |
Where Massachusetts sits
The same service costs 8.3 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
$1,318
AK $3,388TX $407
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.