How much rates vary
Facilitymedian $1,288 · 10th to 90th $525 to $3,548Professionalmedian $2,291 · 10th to 90th $1,175 to $10,715
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 $3,090.30 Typical High $5,128.61 | Facility | None | $2,691.53 | $3,090.30 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $5,011.87 | Professional | None | $1,621.81 | $1,621.81 | $5,011.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,890.45 | Facility | None | $346.74 | $1,047.13 | $3,890.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,513.56 Median $4,265.80 Typical High $10,715.19 | Professional | None | $1,513.56 | $4,265.80 | $10,715.19 |
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 $2,137.96 Median $2,137.96 Typical High $5,370.32 | Professional | None | $2,137.96 | $2,137.96 | $5,370.32 |
Fallon Health Setting Facility Modifier None Typical Low $891.25 Median $1,737.80 Typical High $2,754.23 | Facility | None | $891.25 | $1,737.80 | $2,754.23 |
Fallon Health Setting Professional Modifier None Typical Low $891.25 Median $1,584.89 Typical High $2,290.87 | Professional | None | $891.25 | $1,584.89 | $2,290.87 |
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 $1,737.80 Median $3,162.28 Typical High $4,786.30 | Professional | None | $1,737.80 | $3,162.28 | $4,786.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,890.45 | Facility | None | $346.74 | $1,047.13 | $3,890.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,513.56 Median $4,265.80 Typical High $10,715.19 | Professional | None | $1,513.56 | $4,265.80 | $10,715.19 |
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 $1,737.80 Median $2,454.71 Typical High $6,456.54 | Professional | None | $1,737.80 | $2,454.71 | $6,456.54 |
Well Sense Setting Facility Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $2,398.83 | Facility | None | $1,174.90 | $1,621.81 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,258.93 | $1,513.56 |
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 $812.83 Median $812.83 Typical High $2,511.89 | Professional | 52 · Reduced service | $812.83 | $812.83 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $1,000.00 | Professional | 53 · Discontinued | $323.59 | $323.59 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $3,801.89 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $758.58 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $501.19 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $3,548.13 |
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· 21st of 51
$2,188
AK $6,457TX $1,096
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.