How much rates vary
Facilitymedian $1,738 · 10th to 90th $891 to $5,012Professionalmedian $1,995 · 10th to 90th $1,148 to $8,318
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 $2,691.53 Median $3,388.44 Typical High $6,309.57 | Facility | None | $2,691.53 | $3,388.44 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $3,548.13 | Professional | None | $1,000.00 | $1,000.00 | $3,548.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $691.83 Median $1,862.09 Typical High $5,011.87 | Facility | None | $691.83 | $1,862.09 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,230.27 Median $3,467.37 Typical High $8,317.64 | Professional | None | $1,230.27 | $3,467.37 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,949.84 Typical High $2,884.03 | Facility | None | $954.99 | $1,949.84 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,890.45 | Professional | None | $1,621.81 | $1,621.81 | $3,890.45 |
Fallon Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $3,311.31 | Facility | None | $1,174.90 | $1,584.89 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,621.81 | $1,995.26 |
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 $1,348.96 Median $2,511.89 Typical High $4,365.16 | Professional | None | $1,348.96 | $2,511.89 | $4,365.16 |
Mass General Brigham Setting Facility Modifier None Typical Low $691.83 Median $1,862.09 Typical High $5,011.87 | Facility | None | $691.83 | $1,862.09 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,230.27 Median $3,467.37 Typical High $8,317.64 | Professional | None | $1,230.27 | $3,467.37 | $8,317.64 |
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 $1,445.44 Median $1,862.09 Typical High $5,248.07 | Professional | None | $1,445.44 | $1,862.09 | $5,248.07 |
Well Sense Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,905.46 | Facility | None | $812.83 | $1,122.02 | $1,905.46 |
Well Sense Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Professional | None | $912.01 | $912.01 | $1,096.48 |
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 $489.78 Median $489.78 Typical High $1,778.28 | Professional | 52 · Reduced service | $489.78 | $489.78 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $724.44 | Professional | 53 · Discontinued | $199.53 | $199.53 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $2,691.53 | Professional | 54 · Surgery only | $741.31 | $741.31 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $537.03 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $354.81 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $2,511.89 |
Where Massachusetts sits
The same service costs 3.2 times more in Alaska than in Delaware. 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.
Physician feeFacility fee
AK $8,931DE $2,772
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.