How much rates vary
Facilitymedian $1,622 · 10th to 90th $589 to $5,623Professionalmedian $1,047 · 10th to 90th $575 to $5,495
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 $1,778.28 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,778.28 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,737.80 | Professional | None | $512.86 | $512.86 | $1,737.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $2,041.74 Typical High $5,754.40 | Facility | None | $549.54 | $2,041.74 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $630.96 Median $1,380.38 Typical High $5,495.41 | Professional | None | $630.96 | $1,380.38 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,187.76 Typical High $3,162.28 | Facility | None | $676.08 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,513.56 | Professional | None | $758.58 | $758.58 | $1,513.56 |
Fallon Health Setting Facility Modifier None Typical Low $588.84 Median $776.25 Typical High $3,311.31 | Facility | None | $588.84 | $776.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $912.01 | Professional | None | $676.08 | $776.25 | $912.01 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $645.65 Median $1,202.26 Typical High $1,778.28 | Professional | None | $645.65 | $1,202.26 | $1,778.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $2,041.74 Typical High $5,754.40 | Facility | None | $549.54 | $2,041.74 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $630.96 Median $1,380.38 Typical High $5,495.41 | Professional | None | $630.96 | $1,380.38 | $5,495.41 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $2,511.89 | Professional | None | $676.08 | $977.24 | $2,511.89 |
Well Sense Setting Facility Modifier None Typical Low $467.74 Median $741.31 Typical High $1,096.48 | Facility | None | $467.74 | $741.31 | $1,096.48 |
Well Sense Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $575.44 | Professional | None | $426.58 | $426.58 | $575.44 |
7 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 $257.04 Median $257.04 Typical High $870.96 | Professional | 52 · Reduced service | $257.04 | $257.04 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $346.74 | Professional | 53 · Discontinued | $102.33 | $102.33 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $1,318.26 | Professional | 54 · Surgery only | $380.19 | $380.19 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $263.03 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $173.78 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $1,230.27 |
BCBS Massachusetts Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $117.49 Typical High $190.55 | Professional | AS · PA/NP assist | $93.33 | $117.49 | $190.55 |
Where Massachusetts sits
The same service costs 4.1 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $7,594MT $1,845
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.