How much rates vary
Facilitymedian $1,820 · 10th to 90th $407 to $3,981Professionalmedian $2,630 · 10th to 90th $1,514 to $11,749
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 $1,148.15 Median $1,148.15 Typical High $5,011.87 | Professional | None | $1,148.15 | $1,148.15 | $5,011.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,365.16 | Facility | None | $346.74 | $1,047.13 | $4,365.16 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,737.80 Median $4,265.80 Typical High $11,748.98 | Professional | None | $1,737.80 | $4,265.80 | $11,748.98 |
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 $2,630.27 Median $2,630.27 Typical High $4,570.88 | Professional | None | $2,630.27 | $2,630.27 | $4,570.88 |
Fallon Health Setting Facility Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $3,311.31 | Facility | None | $1,778.28 | $2,187.76 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,187.76 | $2,691.53 |
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 $1,995.26 Median $3,630.78 Typical High $5,495.41 | Professional | None | $1,995.26 | $3,630.78 | $5,495.41 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,365.16 | Facility | None | $346.74 | $1,047.13 | $4,365.16 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,737.80 Median $4,265.80 Typical High $11,748.98 | Professional | None | $1,737.80 | $4,265.80 | $11,748.98 |
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 $1,949.84 Median $2,691.53 Typical High $7,413.10 | Professional | None | $1,949.84 | $2,691.53 | $7,413.10 |
Well Sense Setting Facility Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,570.40 | Facility | None | $1,230.27 | $1,698.24 | $2,570.40 |
Well Sense Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,288.25 | $1,548.82 |
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 $575.44 Median $575.44 Typical High $2,454.71 | Professional | 52 · Reduced service | $575.44 | $575.44 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $1,000.00 | Professional | 53 · Discontinued | $229.09 | $229.09 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $3,715.35 | Professional | 54 · Surgery only | $851.14 | $851.14 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $741.31 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $501.19 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $3,467.37 |
Where Massachusetts sits
The same service costs 5.8 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· 17th of 51
$2,570
AK $6,918TX $1,202
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.