How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,122 to $7,079Professionalmedian $2,188 · 10th to 90th $1,318 to $10,000
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 $2,570.40 Median $3,090.30 Typical High $6,309.57 | Facility | None | $2,570.40 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,148.15 | $1,348.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $9,549.93 | Facility | None | $1,288.25 | $3,467.37 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,445.44 Median $3,548.13 Typical High $10,000.00 | Professional | None | $1,445.44 | $3,548.13 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,570.88 Typical High $5,888.44 | Facility | None | $676.08 | $4,570.88 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $4,466.84 | Professional | None | $1,905.46 | $1,905.46 | $4,466.84 |
Fallon Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,630.78 | Facility | None | $1,479.11 | $1,905.46 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,621.81 | $1,905.46 | $2,344.23 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,621.81 Median $2,951.21 Typical High $6,309.57 | Professional | None | $1,621.81 | $2,951.21 | $6,309.57 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $9,549.93 | Facility | None | $1,288.25 | $3,467.37 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,445.44 Median $3,548.13 Typical High $10,000.00 | Professional | None | $1,445.44 | $3,548.13 | $10,000.00 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $13,489.63 | Facility | None | $1,071.52 | $3,467.37 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $6,309.57 | Professional | None | $1,659.59 | $2,238.72 | $6,309.57 |
Well Sense Setting Facility Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $2,398.83 | Facility | None | $1,071.52 | $1,698.24 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,412.54 | $1,659.59 |
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 $676.08 | Professional | 52 · Reduced service | $575.44 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 53 · Discontinued | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $954.99 |
Where Massachusetts sits
The same service costs 7.1 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
$2,239
AK $6,026TX $851
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.