How much rates vary
Facilitymedian $1,514 · 10th to 90th $407 to $3,631Professionalmedian $2,239 · 10th to 90th $1,380 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 $1,380.38 Median $1,380.38 Typical High $3,630.78 | Professional | None | $1,380.38 | $1,380.38 | $3,630.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,715.35 | Facility | None | $346.74 | $1,047.13 | $3,715.35 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,000.00 | Professional | None | $1,412.54 | $3,801.89 | $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 $1,905.46 Median $1,905.46 Typical High $3,715.35 | Professional | None | $1,905.46 | $1,905.46 | $3,715.35 |
Fallon Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $3,311.31 | Facility | None | $1,479.11 | $1,862.09 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,584.89 | $1,862.09 | $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 $1,621.81 Median $2,951.21 Typical High $4,466.84 | Professional | None | $1,621.81 | $2,951.21 | $4,466.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,715.35 | Facility | None | $346.74 | $1,047.13 | $3,715.35 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,000.00 | Professional | None | $1,412.54 | $3,801.89 | $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 $1,513.56 Median $2,137.96 Typical High $5,623.41 | Professional | None | $1,513.56 | $2,137.96 | $5,623.41 |
Well Sense Setting Facility Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $2,089.30 | Facility | None | $1,000.00 | $1,348.96 | $2,089.30 |
Well Sense Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,122.02 | Professional | None | $933.25 | $933.25 | $1,122.02 |
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 $691.83 Median $691.83 Typical High $1,819.70 | Professional | 52 · Reduced service | $691.83 | $691.83 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $724.44 | Professional | 53 · Discontinued | $275.42 | $275.42 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $549.54 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $363.08 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $2,511.89 |
Where Massachusetts sits
The same service costs 5.8 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· 14th of 51
$2,138
AK $5,623TX $977
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.