How much rates vary
Facilitymedian $2,570 · 10th to 90th $891 to $8,318Professionalmedian $2,399 · 10th to 90th $1,380 to $10,233
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 $2,630.27 Median $3,090.30 Typical High $6,309.57 | Facility | None | $2,630.27 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,412.54 | $2,630.27 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $3,890.45 Typical High $13,182.57 | Facility | None | $724.44 | $3,890.45 | $13,182.57 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,174.90 Median $3,630.78 Typical High $10,232.93 | Professional | None | $1,174.90 | $3,630.78 | $10,232.93 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,187.76 Typical High $3,162.28 | Facility | None | $741.31 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,981.07 | Professional | None | $1,995.26 | $1,995.26 | $3,981.07 |
Fallon Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $3,311.31 | Facility | None | $1,380.38 | $1,905.46 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,698.24 | $1,995.26 | $2,290.87 |
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 $1,659.59 Median $3,090.30 Typical High $4,466.84 | Professional | None | $1,659.59 | $3,090.30 | $4,466.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $3,890.45 Typical High $13,182.57 | Facility | None | $724.44 | $3,890.45 | $13,182.57 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,174.90 Median $3,630.78 Typical High $10,232.93 | Professional | None | $1,174.90 | $3,630.78 | $10,232.93 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $12,022.64 | Facility | None | $1,071.52 | $3,890.45 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $6,606.93 | Professional | None | $1,258.93 | $2,187.76 | $6,606.93 |
Well Sense Setting Facility Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $2,344.23 | Facility | None | $1,148.15 | $1,584.89 | $2,344.23 |
Well Sense Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | None | $954.99 | $954.99 | $1,288.25 |
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 $707.95 Median $707.95 Typical High $1,318.26 | Professional | 52 · Reduced service | $707.95 | $707.95 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $524.81 | Professional | 53 · Discontinued | $281.84 | $281.84 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $389.05 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $263.03 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,819.70 |
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· 14th of 51
$2,399
AK $6,166TX $724
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.