How much rates vary
Facilitymedian $2,344 · 10th to 90th $407 to $4,074Professionalmedian $3,631 · 10th to 90th $1,698 to $15,488
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 $1,513.56 Median $1,513.56 Typical High $4,466.84 | Professional | None | $1,513.56 | $1,513.56 | $4,466.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,495.41 | Facility | None | $346.74 | $1,047.13 | $5,495.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,819.70 Median $5,623.41 Typical High $15,488.17 | Professional | None | $1,819.70 | $5,623.41 | $15,488.17 |
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 $3,630.78 Median $3,630.78 Typical High $7,244.36 | Professional | None | $3,630.78 | $3,630.78 | $7,244.36 |
Fallon Health Setting Facility Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $3,630.78 | Facility | None | $2,344.23 | $2,884.03 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,467.37 | Professional | None | $2,454.71 | $2,884.03 | $3,467.37 |
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 $2,238.72 Median $4,677.35 Typical High $7,079.46 | Professional | None | $2,238.72 | $4,677.35 | $7,079.46 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,495.41 | Facility | None | $346.74 | $1,047.13 | $5,495.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,819.70 Median $5,623.41 Typical High $15,488.17 | Professional | None | $1,819.70 | $5,623.41 | $15,488.17 |
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 $2,137.96 Median $3,388.44 Typical High $10,232.93 | Professional | None | $2,137.96 | $3,388.44 | $10,232.93 |
Well Sense Setting Facility Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $3,467.37 | Facility | None | $1,698.24 | $2,344.23 | $3,467.37 |
Well Sense Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,174.90 | $1,174.90 | $1,412.54 |
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 $758.58 Median $758.58 Typical High $2,238.72 | Professional | 52 · Reduced service | $758.58 | $758.58 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $891.25 | Professional | 53 · Discontinued | $302.00 | $302.00 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $3,311.31 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $660.69 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $446.68 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $3,090.30 |
Where Massachusetts sits
The same service costs 6.2 times more in Alaska than in Delaware. 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
$3,162
AK $9,333DE $1,514
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.