How much rates vary
Facilitymedian $2,344 · 10th to 90th $407 to $4,169Professionalmedian $3,631 · 10th to 90th $2,291 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 $2,290.87 Median $2,290.87 Typical High $6,025.60 | Professional | None | $2,290.87 | $2,290.87 | $6,025.60 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,623.41 | Facility | None | $346.74 | $1,047.13 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,290.87 Median $6,165.95 Typical High $16,982.44 | Professional | None | $2,290.87 | $6,165.95 | $16,982.44 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $6,025.60 | Professional | None | $3,090.30 | $3,090.30 | $6,025.60 |
Fallon Health Setting Facility Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $3,630.78 | Facility | None | $2,344.23 | $2,884.03 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $3,715.35 | Professional | None | $2,511.89 | $3,019.95 | $3,715.35 |
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 $2,630.27 Median $4,786.30 Typical High $7,244.36 | Professional | None | $2,630.27 | $4,786.30 | $7,244.36 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $5,623.41 | Facility | None | $346.74 | $1,047.13 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,290.87 Median $6,165.95 Typical High $16,982.44 | Professional | None | $2,290.87 | $6,165.95 | $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 $2,511.89 Median $3,467.37 Typical High $9,332.54 | Professional | None | $2,511.89 | $3,467.37 | $9,332.54 |
Well Sense Setting Facility Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,659.59 | $2,238.72 | $3,388.44 |
Well Sense Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,548.82 | $1,548.82 | $1,862.09 |
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 $1,148.15 Median $1,148.15 Typical High $3,019.95 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $1,202.26 | Professional | 53 · Discontinued | $457.09 | $457.09 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $4,570.88 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $912.01 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $602.56 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $4,265.80 |
Where Massachusetts sits
The same service costs 14.5 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
$3,388
AK $9,120TX $631
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.