How much rates vary
Facilitymedian $1,778 · 10th to 90th $407 to $3,715Professionalmedian $2,692 · 10th to 90th $1,479 to $12,589
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 $5,370.32 | Facility | None | $2,691.53 | $3,090.30 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $5,370.32 | Professional | None | $1,122.02 | $1,122.02 | $5,370.32 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,073.80 | Facility | None | $346.74 | $1,047.13 | $4,073.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,584.89 Median $3,981.07 Typical High $12,589.25 | Professional | None | $1,584.89 | $3,981.07 | $12,589.25 |
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 $2,511.89 Median $2,511.89 Typical High $4,466.84 | Professional | None | $2,511.89 | $2,511.89 | $4,466.84 |
Fallon Health Setting Facility Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $3,311.31 | Facility | None | $1,659.59 | $2,041.74 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,778.28 | $2,041.74 | $2,511.89 |
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 $1,862.09 Median $3,388.44 Typical High $5,128.61 | Professional | None | $1,862.09 | $3,388.44 | $5,128.61 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,073.80 | Facility | None | $346.74 | $1,047.13 | $4,073.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,584.89 Median $3,981.07 Typical High $12,589.25 | Professional | None | $1,584.89 | $3,981.07 | $12,589.25 |
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 $2,041.74 Median $2,818.38 Typical High $7,244.36 | Professional | None | $2,041.74 | $2,818.38 | $7,244.36 |
Well Sense Setting Facility Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,454.71 | Facility | None | $1,202.26 | $1,659.59 | $2,454.71 |
Well Sense Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,380.38 | $1,659.59 |
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 $562.34 Median $562.34 Typical High $2,630.27 | Professional | 52 · Reduced service | $562.34 | $562.34 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $1,071.52 | Professional | 53 · Discontinued | $223.87 | $223.87 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $3,981.07 | Professional | 54 · Surgery only | $831.76 | $831.76 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $794.33 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $537.03 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $3,715.35 |
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· 26th of 51
$2,455
AK $6,761TX $1,175
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.