How much rates vary
Facilitymedian $2,239 · 10th to 90th $794 to $7,586Professionalmedian $2,089 · 10th to 90th $1,413 to $9,120
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 $2,089.30 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,089.30 | $3,019.95 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $3,630.78 | Professional | None | $1,412.54 | $1,412.54 | $3,630.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $588.84 Median $3,388.44 Typical High $9,549.93 | Facility | None | $588.84 | $3,388.44 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,288.25 Median $3,162.28 Typical High $9,120.11 | Professional | None | $1,288.25 | $3,162.28 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $5,248.07 Typical High $7,943.28 | Facility | None | $676.08 | $5,248.07 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $3,467.37 | Professional | None | $1,862.09 | $1,862.09 | $3,467.37 |
Fallon Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $3,311.31 | Facility | None | $1,202.26 | $1,621.81 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,698.24 | $1,949.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $4,365.16 | Professional | None | $1,445.44 | $2,630.27 | $4,365.16 |
Mass General Brigham Setting Facility Modifier None Typical Low $588.84 Median $3,388.44 Typical High $9,549.93 | Facility | None | $588.84 | $3,388.44 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,288.25 Median $3,162.28 Typical High $9,120.11 | Professional | None | $1,288.25 | $3,162.28 | $9,120.11 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $14,125.38 | Facility | None | $1,071.52 | $3,467.37 | $14,125.38 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $5,495.41 | Professional | None | $1,412.54 | $2,041.74 | $5,495.41 |
Well Sense Setting Facility Modifier None Typical Low $870.96 Median $1,479.11 Typical High $2,238.72 | Facility | None | $870.96 | $1,479.11 | $2,238.72 |
Well Sense Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,258.93 | Professional | None | $933.25 | $933.25 | $1,258.93 |
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 $1,819.70 | Professional | 52 · Reduced service | $707.95 | $707.95 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $724.44 | Professional | 53 · Discontinued | $281.84 | $281.84 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $549.54 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $363.08 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $2,511.89 |
Where Massachusetts sits
The same service costs 11.0 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· 15th of 51
$2,089
AK $5,370TX $490
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.