How much rates vary
Facilitymedian $1,862 · 10th to 90th $741 to $5,495Professionalmedian $1,549 · 10th to 90th $851 to $7,762
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 $3,019.95 Typical High $5,128.61 | Facility | None | $2,691.53 | $3,019.95 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $3,019.95 | Professional | None | $741.31 | $741.31 | $3,019.95 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $2,187.76 Typical High $5,495.41 | Facility | None | $724.44 | $2,187.76 | $5,495.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $912.01 Median $2,238.72 Typical High $7,762.47 | Professional | None | $912.01 | $2,238.72 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,137.96 Typical High $3,090.30 | Facility | None | $446.68 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,445.44 | $2,570.40 |
Fallon Health Setting Facility Modifier None Typical Low $954.99 Median $1,174.90 Typical High $3,311.31 | Facility | None | $954.99 | $1,174.90 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,174.90 | $1,412.54 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $4,168.69 | Professional | None | $1,071.52 | $1,995.26 | $4,168.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $2,187.76 Typical High $5,495.41 | Facility | None | $724.44 | $2,187.76 | $5,495.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $912.01 Median $2,238.72 Typical High $7,762.47 | Professional | None | $912.01 | $2,238.72 | $7,762.47 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $4,168.69 | Professional | None | $1,174.90 | $1,621.81 | $4,168.69 |
Well Sense Setting Facility Modifier None Typical Low $676.08 Median $933.25 Typical High $1,412.54 | Facility | None | $676.08 | $933.25 | $1,412.54 |
Well Sense Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | None | $794.33 | $794.33 | $933.25 |
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 $371.54 Median $371.54 Typical High $1,513.56 | Professional | 52 · Reduced service | $371.54 | $371.54 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $602.56 | Professional | 53 · Discontinued | $147.91 | $147.91 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $2,238.72 | Professional | 54 · Surgery only | $562.34 | $562.34 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $457.09 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $302.00 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $2,089.30 |
Where Massachusetts sits
The same service costs 4.6 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· 25th of 51
$1,585
WI $3,981TX $871
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.