How much rates vary
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 $1,949.84 Median $2,818.38 Typical High $5,128.61 | Facility | None | $1,949.84 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $870.96 | Professional | None | $630.96 | $630.96 | $870.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $954.99 Typical High $3,548.13 | Facility | None | $323.59 | $954.99 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $776.25 Median $1,995.26 Typical High $4,677.35 | Professional | None | $776.25 | $1,995.26 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $1,047.13 Typical High $6,918.31 | Facility | None | $83.18 | $1,047.13 | $6,918.31 |
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 $831.76 Median $1,621.81 Typical High $2,238.72 | Professional | None | $831.76 | $1,621.81 | $2,238.72 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $954.99 Typical High $3,548.13 | Facility | None | $323.59 | $954.99 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $776.25 Median $1,995.26 Typical High $4,677.35 | Professional | None | $776.25 | $1,995.26 | $4,677.35 |
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 $724.44 Median $977.24 Typical High $2,951.21 | Professional | None | $724.44 | $977.24 | $2,951.21 |
Well Sense Setting Facility Modifier None Typical Low $549.54 Median $758.58 Typical High $1,122.02 | Facility | None | $549.54 | $758.58 | $1,122.02 |
Well Sense Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $707.95 | Professional | None | $524.81 | $524.81 | $707.95 |
4 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 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | 54 · Surgery only | $467.74 | $467.74 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $128.82 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $602.56 |
Where Massachusetts sits
The same service costs 3.8 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· 2nd of 51
$1,479
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.