How much rates vary
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 $1,905.46 Median $1,905.46 Typical High $5,011.87 | Professional | None | $1,905.46 | $1,905.46 | $5,011.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,786.30 | Facility | None | $346.74 | $1,047.13 | $4,786.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,949.84 Median $4,570.88 Typical High $13,182.57 | Professional | None | $1,949.84 | $4,570.88 | $13,182.57 |
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 $2,630.27 Median $2,630.27 Typical High $4,897.79 | Professional | None | $2,630.27 | $2,630.27 | $4,897.79 |
Fallon Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $3,630.78 | Facility | None | $2,041.74 | $2,511.89 | $3,630.78 |
Fallon Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,290.87 | $2,630.27 | $3,090.30 |
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 $2,238.72 Median $4,168.69 Typical High $5,888.44 | Professional | None | $2,238.72 | $4,168.69 | $5,888.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,786.30 | Facility | None | $346.74 | $1,047.13 | $4,786.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,949.84 Median $4,570.88 Typical High $13,182.57 | Professional | None | $1,949.84 | $4,570.88 | $13,182.57 |
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 $1,995.26 Median $2,818.38 Typical High $8,511.38 | Professional | None | $1,995.26 | $2,818.38 | $8,511.38 |
Well Sense Setting Facility Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $2,884.03 | Facility | None | $1,412.54 | $1,905.46 | $2,884.03 |
Well Sense Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,318.26 | $1,778.28 |
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 $954.99 Median $954.99 Typical High $2,511.89 | Professional | 52 · Reduced service | $954.99 | $954.99 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $1,023.29 | Professional | 53 · Discontinued | $389.05 | $389.05 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $3,801.89 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $758.58 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $501.19 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $3,548.13 |
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· 15th of 51
$2,951
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.