How much rates vary
Facilitymedian $1,585 · 10th to 90th $525 to $5,623Professionalmedian $1,230 · 10th to 90th $617 to $8,128
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 $870.96 Median $870.96 Typical High $1,513.56 | Professional | None | $870.96 | $870.96 | $1,513.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $575.44 Median $2,398.83 Typical High $8,128.31 | Facility | None | $575.44 | $2,398.83 | $8,128.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $851.14 Median $2,238.72 Typical High $8,128.31 | Professional | None | $851.14 | $2,238.72 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,467.37 Typical High $5,248.07 | Facility | None | $676.08 | $3,467.37 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,818.38 | Professional | None | $1,122.02 | $1,122.02 | $2,818.38 |
Fallon Health Setting Facility Modifier None Typical Low $478.63 Median $912.01 Typical High $2,187.76 | Facility | None | $478.63 | $912.01 | $2,187.76 |
Fallon Health Setting Professional Modifier None Typical Low $467.74 Median $851.14 Typical High $1,230.27 | Professional | None | $467.74 | $851.14 | $1,230.27 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $912.01 Median $1,659.59 Typical High $3,388.44 | Professional | None | $912.01 | $1,659.59 | $3,388.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $575.44 Median $2,398.83 Typical High $8,128.31 | Facility | None | $575.44 | $2,398.83 | $8,128.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $851.14 Median $2,238.72 Typical High $8,128.31 | Professional | None | $851.14 | $2,238.72 | $8,128.31 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $12,302.69 | Facility | None | $851.14 | $2,818.38 | $12,302.69 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $3,715.35 | Professional | None | $912.01 | $1,230.27 | $3,715.35 |
Well Sense Setting Facility Modifier None Typical Low $676.08 Median $912.01 Typical High $1,698.24 | Facility | None | $676.08 | $912.01 | $1,698.24 |
Well Sense Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | None | $630.96 | $630.96 | $758.58 |
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 $436.52 Median $436.52 Typical High $1,258.93 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $501.19 | Professional | 53 · Discontinued | $173.78 | $173.78 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $1,862.09 | Professional | 54 · Surgery only | $645.65 | $645.65 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $371.54 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $251.19 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $1,737.80 |
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· 27th of 51
$1,230
AK $3,467TX $589
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.