How much rates vary
Facilitymedian $1,380 · 10th to 90th $407 to $3,548Professionalmedian $1,905 · 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 $3,090.30 Typical High $5,128.61 | Facility | None | $2,691.53 | $3,090.30 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $3,630.78 | Professional | None | $831.76 | $831.76 | $3,630.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $977.24 Typical High $3,630.78 | Facility | None | $346.74 | $977.24 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,258.93 Median $3,162.28 Typical High $8,709.64 | Professional | None | $1,258.93 | $3,162.28 | $8,709.64 |
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 $1,905.46 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,905.46 | $1,905.46 | $3,388.44 |
Fallon Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $3,311.31 | Facility | None | $1,318.26 | $1,659.59 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,621.81 | $1,995.26 |
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 $1,445.44 Median $2,630.27 Typical High $4,073.80 | Professional | None | $1,445.44 | $2,630.27 | $4,073.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $977.24 Typical High $3,630.78 | Facility | None | $346.74 | $977.24 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,258.93 Median $3,162.28 Typical High $8,709.64 | Professional | None | $1,258.93 | $3,162.28 | $8,709.64 |
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 $1,412.54 Median $1,949.84 Typical High $5,495.41 | Professional | None | $1,412.54 | $1,949.84 | $5,495.41 |
Well Sense Setting Facility Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,862.09 | Facility | None | $912.01 | $1,230.27 | $1,862.09 |
Well Sense Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,122.02 | Professional | None | $933.25 | $933.25 | $1,122.02 |
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 $416.87 Median $416.87 Typical High $1,819.70 | Professional | 52 · Reduced service | $416.87 | $416.87 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $724.44 | Professional | 53 · Discontinued | $165.96 | $165.96 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $2,691.53 | Professional | 54 · Surgery only | $630.96 | $630.96 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $549.54 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $363.08 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $2,511.89 |
Where Massachusetts sits
The same service costs 4.8 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· 18th of 51
$1,905
AK $5,012TX $1,047
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.