How much rates vary
Facilitymedian $1,202 · 10th to 90th $525 to $3,548Professionalmedian $2,042 · 10th to 90th $1,047 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 $1,412.54 Median $1,412.54 Typical High $3,715.35 | Professional | None | $1,412.54 | $1,412.54 | $3,715.35 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,630.78 | Facility | None | $346.74 | $1,047.13 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,380.38 Median $3,715.35 Typical High $11,748.98 | Professional | None | $1,380.38 | $3,715.35 | $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 $1,905.46 Median $1,905.46 Typical High $4,677.35 | Professional | None | $1,905.46 | $1,905.46 | $4,677.35 |
Fallon Health Setting Facility Modifier None Typical Low $812.83 Median $1,584.89 Typical High $2,570.40 | Facility | None | $812.83 | $1,584.89 | $2,570.40 |
Fallon Health Setting Professional Modifier None Typical Low $812.83 Median $1,445.44 Typical High $2,137.96 | Professional | None | $812.83 | $1,445.44 | $2,137.96 |
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 $1,584.89 Median $2,818.38 Typical High $4,365.16 | Professional | None | $1,584.89 | $2,818.38 | $4,365.16 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,630.78 | Facility | None | $346.74 | $1,047.13 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,380.38 Median $3,715.35 Typical High $11,748.98 | Professional | None | $1,380.38 | $3,715.35 | $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 $1,479.11 Median $1,995.26 Typical High $6,309.57 | Professional | None | $1,479.11 | $1,995.26 | $6,309.57 |
Well Sense Setting Facility Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,137.96 | Facility | None | $1,047.13 | $1,445.44 | $2,137.96 |
Well Sense Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | None | $977.24 | $977.24 | $1,174.90 |
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 $707.95 Median $707.95 Typical High $1,862.09 | Professional | 52 · Reduced service | $707.95 | $707.95 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $741.31 | Professional | 53 · Discontinued | $281.84 | $281.84 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $562.34 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $371.54 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $2,630.27 |
Where Massachusetts sits
The same service costs 21.4 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· 19th of 51
$1,905
AK $5,754TX $269
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.