How much rates vary
Facilitymedian $2,089 · 10th to 90th $407 to $4,074Professionalmedian $3,311 · 10th to 90th $1,778 to $13,804
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 $3,090.30 Typical High $5,623.41 | Facility | None | $2,691.53 | $3,090.30 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $5,888.44 | Professional | None | $1,659.59 | $1,659.59 | $5,888.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,897.79 | Facility | None | $346.74 | $1,047.13 | $4,897.79 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,041.74 Median $5,754.40 Typical High $13,803.84 | Professional | None | $2,041.74 | $5,754.40 | $13,803.84 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $1,380.38 | Facility | None | $50.12 | $954.99 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $6,456.54 | Professional | None | $2,691.53 | $2,691.53 | $6,456.54 |
Fallon Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $3,630.78 | Facility | None | $2,089.30 | $2,570.40 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $3,235.94 | Professional | None | $2,238.72 | $2,630.27 | $3,235.94 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,238.72 Median $4,073.80 Typical High $6,165.95 | Professional | None | $2,238.72 | $4,073.80 | $6,165.95 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,897.79 | Facility | None | $346.74 | $1,047.13 | $4,897.79 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,041.74 Median $5,754.40 Typical High $13,803.84 | Professional | None | $2,041.74 | $5,754.40 | $13,803.84 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $3,019.95 Typical High $8,709.64 | Professional | None | $2,137.96 | $3,019.95 | $8,709.64 |
Well Sense Setting Facility Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $3,311.31 | Facility | None | $1,584.89 | $2,187.76 | $3,311.31 |
Well Sense Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,548.82 | $1,819.70 |
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 $831.76 Median $831.76 Typical High $2,951.21 | Professional | 52 · Reduced service | $831.76 | $831.76 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $1,174.90 | Professional | 53 · Discontinued | $331.13 | $331.13 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $4,466.84 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $891.25 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $588.84 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $4,168.69 |
Where Massachusetts sits
The same service costs 22.9 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· 16th of 51
$3,020
AK $8,511TX $372
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.