How much rates vary
Facilitymedian $1,995 · 10th to 90th $407 to $4,074Professionalmedian $2,951 · 10th to 90th $1,738 to $12,882
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 $4,897.79 | Professional | None | $1,737.80 | $1,737.80 | $4,897.79 |
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 $1,819.70 Median $4,466.84 Typical High $12,882.50 | Professional | None | $1,819.70 | $4,466.84 | $12,882.50 |
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 $2,570.40 Median $2,570.40 Typical High $4,786.30 | Professional | None | $2,570.40 | $2,570.40 | $4,786.30 |
Fallon Health Setting Facility Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $3,548.13 | Facility | None | $1,995.26 | $2,511.89 | $3,548.13 |
Fallon Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $3,019.95 | Professional | None | $2,238.72 | $2,630.27 | $3,019.95 |
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 $4,073.80 Typical High $5,754.40 | Professional | None | $2,238.72 | $4,073.80 | $5,754.40 |
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 $1,819.70 Median $4,466.84 Typical High $12,882.50 | Professional | None | $1,819.70 | $4,466.84 | $12,882.50 |
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 $1,905.46 Median $2,754.23 Typical High $8,317.64 | Professional | None | $1,905.46 | $2,754.23 | $8,317.64 |
Well Sense Setting Facility Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $2,818.38 | Facility | None | $1,380.38 | $1,862.09 | $2,818.38 |
Well Sense Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,258.93 | $1,698.24 |
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 $2,454.71 | Professional | 52 · Reduced service | $870.96 | $870.96 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $977.24 | Professional | 53 · Discontinued | $346.74 | $346.74 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $3,630.78 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $724.44 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $3,388.44 |
Where Massachusetts sits
The same service costs 22.9 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
$2,884
AK $7,586TX $331
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.