How much rates vary
Facilitymedian $1,660 · 10th to 90th $479 to $5,129Professionalmedian $1,072 · 10th to 90th $501 to $7,586
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 $1,318.26 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,584.89 | Professional | None | $501.19 | $501.19 | $1,584.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $5,128.61 | Facility | None | $602.56 | $1,698.24 | $5,128.61 |
AllWays Health Partners Setting Professional Modifier None Typical Low $645.65 Median $7,585.78 Typical High $7,585.78 | Professional | None | $645.65 | $7,585.78 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,187.76 Typical High $3,311.31 | Facility | None | $446.68 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,659.59 | Professional | None | $676.08 | $676.08 | $1,659.59 |
Fallon Health Setting Facility Modifier None Typical Low $380.19 Median $457.09 Typical High $489.78 | Facility | None | $380.19 | $457.09 | $489.78 |
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 $549.54 Median $1,023.29 Typical High $1,778.28 | Professional | None | $549.54 | $1,023.29 | $1,778.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $5,128.61 | Facility | None | $602.56 | $1,698.24 | $5,128.61 |
Mass General Brigham Setting Professional Modifier None Typical Low $645.65 Median $7,585.78 Typical High $7,585.78 | Professional | None | $645.65 | $7,585.78 | $7,585.78 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,332.54 | Facility | None | $1,047.13 | $2,344.23 | $9,332.54 |
United Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $2,041.74 | Professional | None | $549.54 | $776.25 | $2,041.74 |
Well Sense Setting Facility Modifier None Typical Low $407.38 Median $562.34 Typical High $1,174.90 | Facility | None | $407.38 | $562.34 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $467.74 | Professional | None | $389.05 | $389.05 | $467.74 |
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 $251.19 Median $251.19 Typical High $794.33 | Professional | 52 · Reduced service | $251.19 | $251.19 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $316.23 | Professional | 53 · Discontinued | $100.00 | $100.00 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $1,202.26 | Professional | 54 · Surgery only | $380.19 | $380.19 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $239.88 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $158.49 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $1,122.02 |
Where Massachusetts sits
The same service costs 5.5 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· 7th of 51
$1,175
AK $2,042UT $372
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.