How much rates vary
Facilitymedian $1,047 · 10th to 90th $479 to $3,981Professionalmedian $1,122 · 10th to 90th $562 to $6,457
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 $2,089.30 Median $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,412.54 | Professional | None | $794.33 | $794.33 | $1,412.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $489.78 Median $1,698.24 Typical High $5,011.87 | Facility | None | $489.78 | $1,698.24 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $741.31 Median $2,041.74 Typical High $6,456.54 | Professional | None | $741.31 | $2,041.74 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $676.08 Typical High $954.99 | Facility | None | $50.12 | $676.08 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,023.29 | $2,570.40 |
Fallon Health Setting Facility Modifier None Typical Low $446.68 Median $851.14 Typical High $2,187.76 | Facility | None | $446.68 | $851.14 | $2,187.76 |
Fallon Health Setting Professional Modifier None Typical Low $426.58 Median $776.25 Typical High $1,122.02 | Professional | None | $426.58 | $776.25 | $1,122.02 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $831.76 Median $1,479.11 Typical High $2,290.87 | Professional | None | $831.76 | $1,479.11 | $2,290.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $489.78 Median $1,698.24 Typical High $5,011.87 | Facility | None | $489.78 | $1,698.24 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $741.31 Median $2,041.74 Typical High $6,456.54 | Professional | None | $741.31 | $2,041.74 | $6,456.54 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $5,754.40 | Facility | None | $1,047.13 | $1,862.09 | $5,754.40 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $3,388.44 | Professional | None | $812.83 | $1,122.02 | $3,388.44 |
Well Sense Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $1,148.15 | Facility | None | $562.34 | $758.58 | $1,148.15 |
Well Sense Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $691.83 | Professional | None | $588.84 | $588.84 | $691.83 |
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 $389.05 Median $389.05 Typical High $1,174.90 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $467.74 | Professional | 53 · Discontinued | $158.49 | $158.49 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $1,778.28 | Professional | 54 · Surgery only | $588.84 | $588.84 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $354.81 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $234.42 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $1,659.59 |
Where Massachusetts sits
The same service costs 5.9 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· 24th of 51
$1,096
AK $3,090TX $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.