How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,072 to $11,220Professionalmedian $3,090 · 10th to 90th $1,514 to $13,490
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 $1,905.46 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,905.46 | $1,905.46 | $2,818.38 |
AllWays Health Partners Setting Facility Modifier None Typical Low $831.76 Median $4,265.80 Typical High $19,498.45 | Facility | None | $831.76 | $4,265.80 | $19,498.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $13,489.63 | Professional | None | $1,380.38 | $4,786.30 | $13,489.63 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,897.79 Typical High $7,079.46 | Facility | None | $741.31 | $4,897.79 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $5,248.07 | Professional | None | $2,691.53 | $2,691.53 | $5,248.07 |
Fallon Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $3,548.13 | Facility | None | $2,041.74 | $2,511.89 | $3,548.13 |
Fallon Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $3,019.95 | Professional | None | $2,238.72 | $2,630.27 | $3,019.95 |
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 $1,995.26 Median $4,073.80 Typical High $5,888.44 | Professional | None | $1,995.26 | $4,073.80 | $5,888.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $831.76 Median $4,265.80 Typical High $19,498.45 | Facility | None | $831.76 | $4,265.80 | $19,498.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $13,489.63 | Professional | None | $1,380.38 | $4,786.30 | $13,489.63 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,595.87 | Facility | None | $1,071.52 | $3,890.45 | $16,595.87 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $2,884.03 Typical High $8,709.64 | Professional | None | $1,230.27 | $2,884.03 | $8,709.64 |
Well Sense Setting Facility Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $3,162.28 | Facility | None | $1,513.56 | $2,089.30 | $3,162.28 |
Well Sense Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,258.93 | $1,698.24 |
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 $954.99 Median $954.99 Typical High $1,412.54 | Professional | 52 · Reduced service | $954.99 | $954.99 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $575.44 | Professional | 53 · Discontinued | $380.19 | $380.19 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $426.58 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $281.84 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,995.26 |
Where Massachusetts sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $18,090KY $3,723
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.