How much rates vary
Facilitymedian $2,344 · 10th to 90th $776 to $7,244Professionalmedian $1,479 · 10th to 90th $871 to $6,310
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 $2,089.30 Median $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $2,511.89 | Professional | None | $851.14 | $851.14 | $2,511.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $588.84 Median $3,090.30 Typical High $10,232.93 | Facility | None | $588.84 | $3,090.30 | $10,232.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $954.99 Median $2,238.72 Typical High $6,309.57 | Professional | None | $954.99 | $2,238.72 | $6,309.57 |
Fallon Health Setting Facility Modifier None Typical Low $891.25 Median $1,202.26 Typical High $3,311.31 | Facility | None | $891.25 | $1,202.26 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,230.27 | $1,445.44 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,023.29 | $1,905.46 | $2,884.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $588.84 Median $3,090.30 Typical High $10,232.93 | Facility | None | $588.84 | $3,090.30 | $10,232.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $954.99 Median $2,238.72 Typical High $6,309.57 | Professional | None | $954.99 | $2,238.72 | $6,309.57 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $14,125.38 | Facility | None | $1,071.52 | $3,467.37 | $14,125.38 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $4,168.69 | Professional | None | $977.24 | $1,412.54 | $4,168.69 |
Well Sense Setting Facility Modifier None Typical Low $758.58 Median $1,047.13 Typical High $2,398.83 | Facility | None | $758.58 | $1,047.13 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
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 $426.58 Median $426.58 Typical High $1,258.93 | Professional | 52 · Reduced service | $426.58 | $426.58 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $501.19 | Professional | 53 · Discontinued | $169.82 | $169.82 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $1,905.46 | Professional | 54 · Surgery only | $630.96 | $630.96 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $380.19 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $251.19 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $1,778.28 |
Where Massachusetts sits
The same service costs 17.4 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· 15th of 51
$1,479
AK $3,715TX $214
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.