How much rates vary
Facilitymedian $2,692 · 10th to 90th $891 to $7,413Professionalmedian $1,660 · 10th to 90th $891 to $7,079
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 $794.33 Median $794.33 Typical High $3,162.28 | Professional | None | $794.33 | $794.33 | $3,162.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,071.52 Median $3,235.94 Typical High $9,120.11 | Facility | None | $1,071.52 | $3,235.94 | $9,120.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $954.99 Median $2,398.83 Typical High $7,079.46 | Professional | None | $954.99 | $2,398.83 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $4,073.80 Typical High $6,025.60 | Facility | None | $446.68 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,513.56 | $2,691.53 |
Fallon Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $3,311.31 | Facility | None | $1,000.00 | $1,258.93 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,230.27 | $1,513.56 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,122.02 Median $2,089.30 Typical High $4,365.16 | Professional | None | $1,122.02 | $2,089.30 | $4,365.16 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,071.52 Median $3,235.94 Typical High $9,120.11 | Facility | None | $1,071.52 | $3,235.94 | $9,120.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $954.99 Median $2,398.83 Typical High $7,079.46 | Professional | None | $954.99 | $2,398.83 | $7,079.46 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $14,791.08 | Facility | None | $1,071.52 | $3,890.45 | $14,791.08 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $4,365.16 | Professional | None | $1,258.93 | $1,778.28 | $4,365.16 |
Well Sense Setting Facility Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,479.11 | Facility | None | $724.44 | $1,000.00 | $1,479.11 |
Well Sense Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | None | $831.76 | $831.76 | $1,000.00 |
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 $398.11 Median $398.11 Typical High $1,584.89 | Professional | 52 · Reduced service | $398.11 | $398.11 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $630.96 | Professional | 53 · Discontinued | $158.49 | $158.49 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $2,398.83 | Professional | 54 · Surgery only | $588.84 | $588.84 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $478.63 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $316.23 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $2,238.72 |
Where Massachusetts sits
The same service costs 5.1 times more in Wisconsin 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· 23rd of 51
$1,778
WI $4,677TX $912
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.