How much rates vary
Facilitymedian $912 · 10th to 90th $447 to $3,388Professionalmedian $1,288 · 10th to 90th $646 to $6,607
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 $912.01 Median $912.01 Typical High $2,754.23 | Professional | None | $912.01 | $912.01 | $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 $870.96 Median $2,344.23 Typical High $6,606.93 | Professional | None | $870.96 | $2,344.23 | $6,606.93 |
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 $1,202.26 Median $1,202.26 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,202.26 | $2,951.21 |
Fallon Health Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $1,698.24 | Facility | None | $501.19 | $977.24 | $1,698.24 |
Fallon Health Setting Professional Modifier None Typical Low $501.19 Median $891.25 Typical High $1,288.25 | Professional | None | $501.19 | $891.25 | $1,288.25 |
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 $977.24 Median $1,698.24 Typical High $2,630.27 | Professional | None | $977.24 | $1,698.24 | $2,630.27 |
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 $870.96 Median $2,344.23 Typical High $6,606.93 | Professional | None | $870.96 | $2,344.23 | $6,606.93 |
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 $954.99 Median $1,288.25 Typical High $3,981.07 | Professional | None | $954.99 | $1,288.25 | $3,981.07 |
Well Sense Setting Facility Modifier None Typical Low $645.65 Median $870.96 Typical High $1,348.96 | Facility | None | $645.65 | $870.96 | $1,348.96 |
Well Sense Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | None | $691.83 | $691.83 | $831.76 |
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 $457.09 Median $457.09 Typical High $1,380.38 | Professional | 52 · Reduced service | $457.09 | $457.09 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $549.54 | Professional | 53 · Discontinued | $181.97 | $181.97 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $2,089.30 | Professional | 54 · Surgery only | $691.83 | $691.83 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $416.87 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $275.42 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $1,949.84 |
Where Massachusetts sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 24th of 51
$1,202
AK $3,548UT $631
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.