How much rates vary
Facilitymedian $1,023 · 10th to 90th $479 to $4,898Professionalmedian $1,023 · 10th to 90th $525 to $6,026
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 $1,949.84 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $2,238.72 | Professional | None | $707.95 | $707.95 | $2,238.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $5,248.07 | Facility | None | $645.65 | $1,995.26 | $5,248.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $676.08 Median $1,905.46 Typical High $6,025.60 | Professional | None | $676.08 | $1,905.46 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $3,311.31 | Facility | None | $831.76 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $2,344.23 | Professional | None | $954.99 | $954.99 | $2,344.23 |
Fallon Health Setting Facility Modifier None Typical Low $407.38 Median $776.25 Typical High $2,691.53 | Facility | None | $407.38 | $776.25 | $2,691.53 |
Fallon Health Setting Professional Modifier None Typical Low $398.11 Median $707.95 Typical High $1,023.29 | Professional | None | $398.11 | $707.95 | $1,023.29 |
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 $776.25 Median $1,412.54 Typical High $2,511.89 | Professional | None | $776.25 | $1,412.54 | $2,511.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $5,248.07 | Facility | None | $645.65 | $1,995.26 | $5,248.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $676.08 Median $1,905.46 Typical High $6,025.60 | Professional | None | $676.08 | $1,905.46 | $6,025.60 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $2,884.03 | Professional | None | $758.58 | $1,096.48 | $2,884.03 |
Well Sense Setting Facility Modifier None Typical Low $575.44 Median $691.83 Typical High $1,071.52 | Facility | None | $575.44 | $691.83 | $1,071.52 |
Well Sense Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | None | $549.54 | $549.54 | $660.69 |
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 $354.81 Median $354.81 Typical High $1,122.02 | Professional | 52 · Reduced service | $354.81 | $354.81 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $446.68 | Professional | 53 · Discontinued | $141.25 | $141.25 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $1,659.59 | Professional | 54 · Surgery only | $537.03 | $537.03 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $338.84 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $223.87 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $1,548.82 |
Where Massachusetts sits
The same service costs 5.8 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· 27th of 51
$1,023
AK $2,818UT $490
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.