How much rates vary
Facilitymedian $2,344 · 10th to 90th $955 to $6,918Professionalmedian $2,042 · 10th to 90th $1,122 to $8,710
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 $954.99 Median $954.99 Typical High $3,467.37 | Professional | None | $954.99 | $954.99 | $3,467.37 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $3,467.37 Typical High $9,549.93 | Facility | None | $724.44 | $3,467.37 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,288.25 Median $3,548.13 Typical High $8,709.64 | Professional | None | $1,288.25 | $3,548.13 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,890.45 Typical High $5,754.40 | Facility | None | $954.99 | $3,890.45 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,890.45 | Professional | None | $1,659.59 | $1,659.59 | $3,890.45 |
Fallon Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $3,311.31 | Facility | None | $1,202.26 | $1,659.59 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,698.24 | $2,089.30 |
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 $1,412.54 Median $2,570.40 Typical High $5,495.41 | Professional | None | $1,412.54 | $2,570.40 | $5,495.41 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $3,467.37 Typical High $9,549.93 | Facility | None | $724.44 | $3,467.37 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,288.25 Median $3,548.13 Typical High $8,709.64 | Professional | None | $1,288.25 | $3,548.13 | $8,709.64 |
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 $1,348.96 Median $1,862.09 Typical High $5,495.41 | Professional | None | $1,348.96 | $1,862.09 | $5,495.41 |
Well Sense Setting Facility Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,290.87 | Facility | None | $1,071.52 | $1,479.11 | $2,290.87 |
Well Sense Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,071.52 | Professional | None | $891.25 | $891.25 | $1,071.52 |
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 $478.63 Median $478.63 Typical High $1,737.80 | Professional | 52 · Reduced service | $478.63 | $478.63 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $691.83 | Professional | 53 · Discontinued | $190.55 | $190.55 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $2,570.40 | Professional | 54 · Surgery only | $724.44 | $724.44 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $512.86 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $346.74 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $2,398.83 |
Where Massachusetts sits
The same service costs 6.6 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· 15th of 51
$2,188
AK $5,248TX $794
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.