How much rates vary
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 $5,128.61 | Facility | None | $2,691.53 | $3,090.30 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $4,570.88 | Professional | None | $1,023.29 | $1,023.29 | $4,570.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,981.07 | Facility | None | $346.74 | $1,047.13 | $3,981.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,445.44 Median $3,801.89 Typical High $13,182.57 | Professional | None | $1,445.44 | $3,801.89 | $13,182.57 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $4,168.69 | Professional | None | $2,344.23 | $2,344.23 | $4,168.69 |
Fallon Health Setting Facility Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $3,311.31 | Facility | None | $1,621.81 | $1,995.26 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,698.24 | $1,995.26 | $2,398.83 |
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 $1,778.28 Median $3,235.94 Typical High $4,897.79 | Professional | None | $1,778.28 | $3,235.94 | $4,897.79 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,981.07 | Facility | None | $346.74 | $1,047.13 | $3,981.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,445.44 Median $3,801.89 Typical High $13,182.57 | Professional | None | $1,445.44 | $3,801.89 | $13,182.57 |
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 $1,621.81 Median $2,398.83 Typical High $6,760.83 | Professional | None | $1,621.81 | $2,398.83 | $6,760.83 |
Well Sense Setting Facility Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,290.87 | Facility | None | $1,122.02 | $1,548.82 | $2,290.87 |
Well Sense Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,174.90 | $1,174.90 | $1,412.54 |
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 $512.86 Median $512.86 Typical High $2,238.72 | Professional | 52 · Reduced service | $512.86 | $512.86 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $912.01 | Professional | 53 · Discontinued | $204.17 | $204.17 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $3,388.44 | Professional | 54 · Surgery only | $776.25 | $776.25 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $676.08 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $457.09 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $3,162.28 |
Where Massachusetts sits
The same service costs 5.6 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· 17th of 51
$2,291
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.