How much rates vary
Facilitymedian $1,905 · 10th to 90th $407 to $4,074Professionalmedian $2,692 · 10th to 90th $1,738 to $12,023
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 $1,737.80 Median $1,737.80 Typical High $4,570.88 | Professional | None | $1,737.80 | $1,737.80 | $4,570.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,365.16 | Facility | None | $346.74 | $1,047.13 | $4,365.16 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,621.81 Median $4,073.80 Typical High $12,022.64 | Professional | None | $1,621.81 | $4,073.80 | $12,022.64 |
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 $2,398.83 Median $2,398.83 Typical High $4,466.84 | Professional | None | $2,398.83 | $2,398.83 | $4,466.84 |
Fallon Health Setting Facility Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $3,311.31 | Facility | None | $1,819.70 | $2,290.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,754.23 | Professional | None | $2,041.74 | $2,398.83 | $2,754.23 |
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 $2,041.74 Median $3,715.35 Typical High $5,248.07 | Professional | None | $2,041.74 | $3,715.35 | $5,248.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,365.16 | Facility | None | $346.74 | $1,047.13 | $4,365.16 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,621.81 Median $4,073.80 Typical High $12,022.64 | Professional | None | $1,621.81 | $4,073.80 | $12,022.64 |
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 $1,778.28 Median $2,570.40 Typical High $7,762.47 | Professional | None | $1,778.28 | $2,570.40 | $7,762.47 |
Well Sense Setting Facility Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,630.27 | Facility | None | $1,258.93 | $1,737.80 | $2,630.27 |
Well Sense Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,174.90 | $1,584.89 |
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 $870.96 Median $870.96 Typical High $2,290.87 | Professional | 52 · Reduced service | $870.96 | $870.96 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $912.01 | Professional | 53 · Discontinued | $346.74 | $346.74 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $3,388.44 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $676.08 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $457.09 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $3,162.28 |
Where Massachusetts sits
The same service costs 6.0 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· 13th of 51
$2,692
AK $7,079TX $1,175
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.