How much rates vary
Facilitymedian $5,129 · 10th to 90th $3,467 to $10,000Professionalmedian $6,310 · 10th to 90th $3,020 to $19,055
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 $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $7,943.28 Median $10,000.00 Typical High $10,000.00 | Professional | None | $7,943.28 | $10,000.00 | $10,000.00 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3,019.95 Median $5,888.44 Typical High $12,882.50 | Facility | None | $3,019.95 | $5,888.44 | $12,882.50 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3,801.89 Median $8,912.51 Typical High $19,054.61 | Professional | None | $3,801.89 | $8,912.51 | $19,054.61 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,073.80 | Professional | None | $2,951.21 | $2,951.21 | $4,073.80 |
Fallon Health Setting Facility Modifier None Typical Low $4,265.80 Median $5,370.32 Typical High $6,760.83 | Facility | None | $4,265.80 | $5,370.32 | $6,760.83 |
Fallon Health Setting Professional Modifier None Typical Low $4,570.88 Median $5,370.32 Typical High $6,918.31 | Professional | None | $4,570.88 | $5,370.32 | $6,918.31 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $3,019.95 Median $6,165.95 Typical High $13,489.63 | Facility | None | $3,019.95 | $6,165.95 | $13,489.63 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3,630.78 Median $6,456.54 Typical High $11,220.18 | Professional | None | $3,630.78 | $6,456.54 | $11,220.18 |
Health New England Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Mass General Brigham Setting Facility Modifier None Typical Low $3,019.95 Median $5,888.44 Typical High $12,882.50 | Facility | None | $3,019.95 | $5,888.44 | $12,882.50 |
Mass General Brigham Setting Professional Modifier None Typical Low $3,801.89 Median $8,912.51 Typical High $19,054.61 | Professional | None | $3,801.89 | $8,912.51 | $19,054.61 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,511.89 | $6,309.57 | $13,489.63 |
United Setting Professional Modifier None Typical Low $186.21 Median $5,011.87 Typical High $12,882.50 | Professional | None | $186.21 | $5,011.87 | $12,882.50 |
Well Sense Setting Facility Modifier None Typical Low $3,467.37 Median $4,265.80 Typical High $5,754.40 | Facility | None | $3,467.37 | $4,265.80 | $5,754.40 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,511.89 | $3,019.95 | $3,019.95 |
5 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 $3,981.07 Median $5,011.87 Typical High $5,011.87 | Professional | 52 · Reduced service | $3,981.07 | $5,011.87 | $5,011.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | 53 · Discontinued | $1,584.89 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5,888.44 Median $7,585.78 Typical High $7,585.78 | Professional | 54 · Surgery only | $5,888.44 | $7,585.78 | $7,585.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,202.26 Median $1,513.56 Typical High $1,513.56 | Professional | 55 · Aftercare only | $1,202.26 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | 56 · Pre-op care only | $794.33 | $1,000.00 | $1,000.00 |
Where Massachusetts sits
The same service costs 14.1 times more in Alaska than in Missouri. 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· 4th of 51
$6,026
AK $8,511MO $603
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.