How much rates vary
Facilitymedian $692 · 10th to 90th $347 to $3,548Professionalmedian $955 · 10th to 90th $490 to $16,596
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 $2,818.38 Typical High $5,128.61 | Facility | None | $2,691.53 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,290.87 | $2,754.23 | $2,754.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $776.25 Typical High $3,548.13 | Facility | None | $346.74 | $776.25 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $478.63 Median $1,202.26 Typical High $16,595.87 | Professional | None | $478.63 | $1,202.26 | $16,595.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,258.93 | Professional | None | $794.33 | $794.33 | $1,258.93 |
Fallon Health Setting Facility Modifier None Typical Low $549.54 Median $645.65 Typical High $3,311.31 | Facility | None | $549.54 | $645.65 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $891.25 | Professional | None | $562.34 | $660.69 | $891.25 |
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 $489.78 Median $912.01 Typical High $1,318.26 | Professional | None | $489.78 | $912.01 | $1,318.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $776.25 Typical High $3,548.13 | Facility | None | $346.74 | $776.25 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $478.63 Median $1,202.26 Typical High $16,595.87 | Professional | None | $478.63 | $1,202.26 | $16,595.87 |
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 $467.74 Median $616.60 Typical High $1,778.28 | Professional | None | $467.74 | $616.60 | $1,778.28 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $489.78 Typical High $691.83 | Facility | None | $346.74 | $489.78 | $691.83 |
Well Sense Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,905.46 | $1,905.46 | $2,570.40 |
4 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 54 · Surgery only Typical Low $1,737.80 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,737.80 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $346.74 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,949.84 | $1,949.84 |
Where Massachusetts sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 9th of 51
$912
NY $3,802NC $324
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.