How much rates vary
Facilitymedian $1,622 · 10th to 90th $407 to $3,715Professionalmedian $2,399 · 10th to 90th $1,479 to $10,000
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 $1,479.11 Median $1,479.11 Typical High $3,890.45 | Professional | None | $1,479.11 | $1,479.11 | $3,890.45 |
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 $4,073.80 Typical High $10,000.00 | Professional | None | $1,513.56 | $4,073.80 | $10,000.00 |
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 $1,995.26 Median $1,995.26 Typical High $3,890.45 | Professional | None | $1,995.26 | $1,995.26 | $3,890.45 |
Fallon Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $3,311.31 | Facility | None | $1,548.82 | $1,949.84 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,995.26 | $2,454.71 |
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 $4,073.80 Typical High $10,000.00 | Professional | None | $1,513.56 | $4,073.80 | $10,000.00 |
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 $1,621.81 Median $2,238.72 Typical High $6,025.60 | Professional | None | $1,621.81 | $2,238.72 | $6,025.60 |
Well Sense Setting Facility Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $2,187.76 | Facility | None | $1,071.52 | $1,445.44 | $2,187.76 |
Well Sense Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,202.26 | Professional | None | $1,000.00 | $1,000.00 | $1,202.26 |
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 $741.31 Median $741.31 Typical High $1,905.46 | Professional | 52 · Reduced service | $741.31 | $741.31 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $776.25 | Professional | 53 · Discontinued | $295.12 | $295.12 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $575.44 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $389.05 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $2,691.53 |
Where Massachusetts sits
The same service costs 7.8 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· 15th of 51
$2,239
AK $5,888TX $759
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.