How much rates vary
Facilitymedian $2,291 · 10th to 90th $794 to $7,762Professionalmedian $1,660 · 10th to 90th $1,000 to $7,079
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 $2,691.53 Median $3,090.30 Typical High $6,309.57 | Facility | None | $2,691.53 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $2,884.03 | Professional | None | $954.99 | $954.99 | $2,884.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $691.83 Median $2,818.38 Typical High $8,709.64 | Facility | None | $691.83 | $2,818.38 | $8,709.64 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,096.48 Median $2,511.89 Typical High $7,079.46 | Professional | None | $1,096.48 | $2,511.89 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $6,606.93 Typical High $10,000.00 | Facility | None | $446.68 | $6,606.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,380.38 | $2,754.23 |
Fallon Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $3,311.31 | Facility | None | $1,047.13 | $1,348.96 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,380.38 | $1,584.89 |
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 $1,148.15 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,148.15 | $2,137.96 | $3,162.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $691.83 Median $2,818.38 Typical High $8,709.64 | Facility | None | $691.83 | $2,818.38 | $8,709.64 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,096.48 Median $2,511.89 Typical High $7,079.46 | Professional | None | $1,096.48 | $2,511.89 | $7,079.46 |
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 $1,174.90 Median $1,621.81 Typical High $4,570.88 | Professional | None | $1,174.90 | $1,621.81 | $4,570.88 |
Well Sense Setting Facility Modifier None Typical Low $851.14 Median $1,174.90 Typical High $2,398.83 | Facility | None | $851.14 | $1,174.90 | $2,398.83 |
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 $478.63 Median $478.63 Typical High $1,445.44 | Professional | 52 · Reduced service | $478.63 | $478.63 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $575.44 | Professional | 53 · Discontinued | $190.55 | $190.55 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $2,137.96 | Professional | 54 · Surgery only | $707.95 | $707.95 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $426.58 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $288.40 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $1,995.26 |
Where Massachusetts sits
The same service costs 7.9 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· 17th of 51
$1,660
AK $4,266TX $537
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.