How much rates vary
Facilitymedian $2,692 · 10th to 90th $891 to $13,804Professionalmedian $1,995 · 10th to 90th $1,202 to $8,710
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 $1,949.84 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,235.94 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $3,467.37 | Professional | None | $1,148.15 | $1,148.15 | $3,467.37 |
AllWays Health Partners Setting Facility Modifier None Typical Low $707.95 Median $3,890.45 Typical High $14,454.40 | Facility | None | $707.95 | $3,890.45 | $14,454.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,318.26 Median $3,019.95 Typical High $8,709.64 | Professional | None | $1,318.26 | $3,019.95 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $12,302.69 Typical High $18,620.87 | Facility | None | $831.76 | $12,302.69 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,311.31 | Professional | None | $1,698.24 | $1,698.24 | $3,311.31 |
Fallon Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $3,311.31 | Facility | None | $1,202.26 | $1,659.59 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,698.24 | $1,949.84 |
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 $1,412.54 Median $2,570.40 Typical High $3,890.45 | Professional | None | $1,412.54 | $2,570.40 | $3,890.45 |
Mass General Brigham Setting Facility Modifier None Typical Low $707.95 Median $3,890.45 Typical High $14,454.40 | Facility | None | $707.95 | $3,890.45 | $14,454.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,318.26 Median $3,019.95 Typical High $8,709.64 | Professional | None | $1,318.26 | $3,019.95 | $8,709.64 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $19,054.61 | Facility | None | $1,071.52 | $3,890.45 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $5,754.40 | Professional | None | $1,348.96 | $1,905.46 | $5,754.40 |
Well Sense Setting Facility Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $8,511.38 | Facility | None | $1,047.13 | $1,659.59 | $8,511.38 |
Well Sense Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,202.26 | Professional | None | $891.25 | $891.25 | $1,202.26 |
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 $575.44 Median $575.44 Typical High $1,737.80 | Professional | 52 · Reduced service | $575.44 | $575.44 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $691.83 | Professional | 53 · Discontinued | $229.09 | $229.09 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $2,570.40 | Professional | 54 · Surgery only | $870.96 | $870.96 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $524.81 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $346.74 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $2,398.83 |
Where Massachusetts sits
The same service costs 7.6 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· 20th of 51
$1,995
AK $5,129TX $676
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.