How much rates vary
Facilitymedian $2,455 · 10th to 90th $407 to $4,365Professionalmedian $3,890 · 10th to 90th $2,455 to $16,982
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 $5,623.41 | Facility | None | $2,691.53 | $3,090.30 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $6,606.93 | Professional | None | $2,454.71 | $2,454.71 | $6,606.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $6,025.60 | Facility | None | $346.74 | $1,047.13 | $6,025.60 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,511.89 Median $6,606.93 Typical High $16,982.44 | Professional | None | $2,511.89 | $6,606.93 | $16,982.44 |
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 $3,311.31 Median $3,311.31 Typical High $6,456.54 | Professional | None | $3,311.31 | $3,311.31 | $6,456.54 |
Fallon Health Setting Facility Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $3,890.45 | Facility | None | $2,511.89 | $3,090.30 | $3,890.45 |
Fallon Health Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $3,981.07 | Professional | None | $2,754.23 | $3,235.94 | $3,981.07 |
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 $2,818.38 Median $5,128.61 Typical High $7,762.47 | Professional | None | $2,818.38 | $5,128.61 | $7,762.47 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $6,025.60 | Facility | None | $346.74 | $1,047.13 | $6,025.60 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,511.89 Median $6,606.93 Typical High $16,982.44 | Professional | None | $2,511.89 | $6,606.93 | $16,982.44 |
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 $2,691.53 Median $3,715.35 Typical High $10,000.00 | Professional | None | $2,691.53 | $3,715.35 | $10,000.00 |
Well Sense Setting Facility Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,630.78 | Facility | None | $1,778.28 | $2,398.83 | $3,630.78 |
Well Sense Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,659.59 | $1,995.26 |
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 $1,202.26 Median $1,202.26 Typical High $3,235.94 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $1,318.26 | Professional | 53 · Discontinued | $489.78 | $489.78 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $4,897.79 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $977.24 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $660.69 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $4,570.88 |
Where Massachusetts sits
The same service costs 16.2 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
$3,631
AK $9,772TX $603
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.