How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,023 to $7,244Professionalmedian $2,188 · 10th to 90th $1,413 to $9,550
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 $1,412.54 Median $1,412.54 Typical High $3,311.31 | Professional | None | $1,412.54 | $1,412.54 | $3,311.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $758.58 Median $2,884.03 Typical High $10,232.93 | Facility | None | $758.58 | $2,884.03 | $10,232.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,380.38 Median $3,388.44 Typical High $9,549.93 | Professional | None | $1,380.38 | $3,388.44 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $1,380.38 Typical High $2,691.53 | Facility | None | $50.12 | $1,380.38 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,630.78 | Professional | None | $1,949.84 | $1,949.84 | $3,630.78 |
Fallon Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,630.78 | Facility | None | $1,479.11 | $1,905.46 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,238.72 | Professional | None | $1,698.24 | $1,949.84 | $2,238.72 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,096.48 | $4,073.80 | $14,125.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,659.59 Median $3,019.95 Typical High $4,365.16 | Professional | None | $1,659.59 | $3,019.95 | $4,365.16 |
Mass General Brigham Setting Facility Modifier None Typical Low $758.58 Median $2,884.03 Typical High $10,232.93 | Facility | None | $758.58 | $2,884.03 | $10,232.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,380.38 Median $3,388.44 Typical High $9,549.93 | Professional | None | $1,380.38 | $3,388.44 | $9,549.93 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $12,589.25 | Facility | None | $1,258.93 | $4,073.80 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $6,309.57 | Professional | None | $1,445.44 | $2,089.30 | $6,309.57 |
Well Sense Setting Facility Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,089.30 | Facility | None | $1,023.29 | $1,380.38 | $2,089.30 |
Well Sense Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,096.48 | Professional | None | $812.83 | $812.83 | $1,096.48 |
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 $707.95 Median $707.95 Typical High $1,659.59 | Professional | 52 · Reduced service | $707.95 | $707.95 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $660.69 | Professional | 53 · Discontinued | $281.84 | $281.84 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $501.19 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $331.13 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $2,290.87 |
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· 14th of 51
$2,188
AK $5,754TX $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.