How much rates vary
Facilitymedian $3,311 · 10th to 90th $407 to $5,495Professionalmedian $6,761 · 10th to 90th $3,236 to $23,988
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 $3,162.28 Typical High $5,623.41 | Facility | None | $2,691.53 | $3,162.28 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $4,786.30 | Professional | None | $3,162.28 | $3,162.28 | $4,786.30 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $8,128.31 | Facility | None | $346.74 | $1,047.13 | $8,128.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3,630.78 Median $9,332.54 Typical High $23,988.33 | Professional | None | $3,630.78 | $9,332.54 | $23,988.33 |
Fallon Health Setting Facility Modifier None Typical Low $3,311.31 Median $4,466.84 Typical High $5,495.41 | Facility | None | $3,311.31 | $4,466.84 | $5,495.41 |
Fallon Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $6,456.54 | Professional | None | $4,073.80 | $4,786.30 | $6,456.54 |
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 $3,981.07 Median $7,585.78 Typical High $10,471.29 | Professional | None | $3,981.07 | $7,585.78 | $10,471.29 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $8,128.31 | Facility | None | $346.74 | $1,047.13 | $8,128.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $3,630.78 Median $9,332.54 Typical High $23,988.33 | Professional | None | $3,630.78 | $9,332.54 | $23,988.33 |
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 $3,630.78 Median $4,786.30 Typical High $14,791.08 | Professional | None | $3,630.78 | $4,786.30 | $14,791.08 |
Well Sense Setting Facility Modifier None Typical Low $2,630.27 Median $3,630.78 Typical High $5,370.32 | Facility | None | $2,630.27 | $3,630.78 | $5,370.32 |
Well Sense Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,311.31 | Professional | None | $2,454.71 | $2,454.71 | $3,311.31 |
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 $1,584.89 Median $1,584.89 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,584.89 | $1,584.89 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $954.99 | Professional | 53 · Discontinued | $630.96 | $630.96 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,398.83 Typical High $3,630.78 | Professional | 54 · Surgery only | $2,398.83 | $2,398.83 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $478.63 Typical High $724.44 | Professional | 55 · Aftercare only | $478.63 | $478.63 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $478.63 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,238.72 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,238.72 | $3,388.44 |
Where Massachusetts sits
The same service costs 27.5 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· 12th of 51
$6,457
AK $14,454TX $525
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.