How much rates vary
Facilitymedian $1,380 · 10th to 90th $468 to $5,129Professionalmedian $661 · 10th to 90th $389 to $3,802
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 $371.54 Median $371.54 Typical High $1,000.00 | Professional | None | $371.54 | $371.54 | $1,000.00 |
AllWays Health Partners Setting Facility Modifier None Typical Low $512.86 Median $1,621.81 Typical High $4,168.69 | Facility | None | $512.86 | $1,621.81 | $4,168.69 |
AllWays Health Partners Setting Professional Modifier None Typical Low $426.58 Median $891.25 Typical High $3,801.89 | Professional | None | $426.58 | $891.25 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,677.35 Typical High $7,079.46 | Facility | None | $676.08 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,071.52 | Professional | None | $537.03 | $537.03 | $1,071.52 |
Fallon Health Setting Facility Modifier None Typical Low $436.52 Median $575.44 Typical High $3,311.31 | Facility | None | $436.52 | $575.44 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $660.69 | Professional | None | $489.78 | $562.34 | $660.69 |
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 $467.74 Median $851.14 Typical High $1,288.25 | Professional | None | $467.74 | $851.14 | $1,288.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $512.86 Median $1,621.81 Typical High $4,168.69 | Facility | None | $512.86 | $1,621.81 | $4,168.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $426.58 Median $891.25 Typical High $3,801.89 | Professional | None | $426.58 | $891.25 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $11,481.54 | Facility | None | $1,047.13 | $2,344.23 | $11,481.54 |
United Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $1,737.80 | Professional | None | $426.58 | $630.96 | $1,737.80 |
Well Sense Setting Facility Modifier None Typical Low $316.23 Median $588.84 Typical High $2,398.83 | Facility | None | $316.23 | $588.84 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $354.81 | Professional | None | $263.03 | $263.03 | $354.81 |
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 $186.21 Median $186.21 Typical High $501.19 | Professional | 52 · Reduced service | $186.21 | $186.21 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $199.53 | Professional | 53 · Discontinued | $74.13 | $74.13 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $741.31 | Professional | 54 · Surgery only | $275.42 | $275.42 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $151.36 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $100.00 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $691.83 |
Where Massachusetts sits
The same service costs 7.2 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· 13th of 51
$692
AK $1,622TX $224
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.