How much rates vary
Facilitymedian $1,445 · 10th to 90th $661 to $5,012Professionalmedian $1,122 · 10th to 90th $661 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 $1,778.28 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 $645.65 Median $645.65 Typical High $1,737.80 | Professional | None | $645.65 | $645.65 | $1,737.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $2,041.74 Typical High $5,623.41 | Facility | None | $549.54 | $2,041.74 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $724.44 Median $1,698.24 Typical High $5,888.44 | Professional | None | $724.44 | $1,698.24 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,691.53 Typical High $4,073.80 | Facility | None | $676.08 | $2,691.53 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,862.09 | Professional | None | $933.25 | $933.25 | $1,862.09 |
Fallon Health Setting Facility Modifier None Typical Low $724.44 Median $933.25 Typical High $3,311.31 | Facility | None | $724.44 | $933.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,096.48 | Professional | None | $831.76 | $954.99 | $1,096.48 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $794.33 Median $1,445.44 Typical High $2,187.76 | Professional | None | $794.33 | $1,445.44 | $2,187.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $2,041.74 Typical High $5,623.41 | Facility | None | $549.54 | $2,041.74 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $724.44 Median $1,698.24 Typical High $5,888.44 | Professional | None | $724.44 | $1,698.24 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,162.28 | Professional | None | $758.58 | $1,071.52 | $3,162.28 |
Well Sense Setting Facility Modifier None Typical Low $537.03 Median $794.33 Typical High $1,230.27 | Facility | None | $537.03 | $794.33 | $1,230.27 |
Well Sense Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $602.56 | Professional | None | $446.68 | $446.68 | $602.56 |
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 $323.59 Median $323.59 Typical High $870.96 | Professional | 52 · Reduced service | $323.59 | $323.59 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $346.74 | Professional | 53 · Discontinued | $128.82 | $128.82 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $1,288.25 | Professional | 54 · Surgery only | $478.63 | $478.63 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $257.04 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $173.78 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $1,202.26 |
Where Massachusetts sits
The same service costs 8.5 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· 16th of 51
$1,122
AK $2,884TX $339
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.