How much rates vary
Facilitymedian $1,622 · 10th to 90th $407 to $3,715Professionalmedian $2,291 · 10th to 90th $1,413 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 $1,412.54 Median $1,412.54 Typical High $3,801.89 | Professional | None | $1,412.54 | $1,412.54 | $3,801.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,890.45 | Facility | None | $346.74 | $1,047.13 | $3,890.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,348.96 Median $3,548.13 Typical High $10,000.00 | Professional | None | $1,348.96 | $3,548.13 | $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 $1,995.26 Median $1,995.26 Typical High $3,715.35 | Professional | None | $1,995.26 | $1,995.26 | $3,715.35 |
Fallon Health Setting Facility Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,311.31 | Facility | None | $1,584.89 | $1,995.26 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,778.28 | $2,041.74 | $2,344.23 |
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 $1,737.80 Median $3,162.28 Typical High $4,466.84 | Professional | None | $1,737.80 | $3,162.28 | $4,466.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $3,890.45 | Facility | None | $346.74 | $1,047.13 | $3,890.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,348.96 Median $3,548.13 Typical High $10,000.00 | Professional | None | $1,348.96 | $3,548.13 | $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 $1,479.11 Median $2,137.96 Typical High $6,456.54 | Professional | None | $1,479.11 | $2,137.96 | $6,456.54 |
Well Sense Setting Facility Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,187.76 | Facility | None | $1,071.52 | $1,479.11 | $2,187.76 |
Well Sense Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,318.26 | Professional | None | $977.24 | $977.24 | $1,318.26 |
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 $1,862.09 | Professional | 52 · Reduced service | $707.95 | $707.95 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $758.58 | Professional | 53 · Discontinued | $281.84 | $281.84 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $562.34 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $380.19 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $2,630.27 |
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
$2,239
AK $5,888TX $1,000
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.