How much rates vary
Facilitymedian $3,802 · 10th to 90th $2,399 to $7,762Professionalmedian $4,365 · 10th to 90th $2,291 to $16,982
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 $4,365.16 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,365.16 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $4,365.16 | Professional | None | $3,981.07 | $4,365.16 | $4,365.16 |
AllWays Health Partners Setting Facility Modifier None Typical Low $2,398.83 Median $5,248.07 Typical High $9,549.93 | Facility | None | $2,398.83 | $5,248.07 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $16,982.44 | Professional | None | $2,630.27 | $6,165.95 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,311.31 | Professional | None | $2,290.87 | $2,290.87 | $3,311.31 |
Fallon Health Setting Facility Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $5,888.44 | Facility | None | $2,951.21 | $3,801.89 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,890.45 Typical High $4,786.30 | Professional | None | $3,388.44 | $3,890.45 | $4,786.30 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,398.83 Median $5,248.07 Typical High $11,481.54 | Facility | None | $2,398.83 | $5,248.07 | $11,481.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,511.89 Median $4,786.30 Typical High $7,585.78 | Professional | None | $2,511.89 | $4,786.30 | $7,585.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $2,398.83 Median $5,248.07 Typical High $9,549.93 | Facility | None | $2,398.83 | $5,248.07 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $16,982.44 | Professional | None | $2,630.27 | $6,165.95 | $16,982.44 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $5,623.41 Typical High $11,481.54 | Facility | None | $2,238.72 | $5,623.41 | $11,481.54 |
United Setting Professional Modifier None Typical Low $186.21 Median $3,388.44 Typical High $8,709.64 | Professional | None | $186.21 | $3,388.44 | $8,709.64 |
Well Sense Setting Facility Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $3,981.07 | Facility | None | $2,344.23 | $2,951.21 | $3,981.07 |
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 $1,995.26 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,995.26 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | 53 · Discontinued | $794.33 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $3,019.95 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $602.56 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $398.11 | $436.52 | $436.52 |
Where Massachusetts sits
The same service costs 9.3 times more in Alaska than in Indiana. 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· 3rd of 51
$4,074
AK $6,457IN $692
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.