How much rates vary
Facilitymedian $1,698 · 10th to 90th $708 to $8,318Professionalmedian $1,000 · 10th to 90th $646 to $4,898
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 $912.01 Median $2,691.53 Typical High $5,128.61 | Facility | None | $912.01 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,862.09 | Professional | None | $602.56 | $602.56 | $1,862.09 |
AllWays Health Partners Setting Facility Modifier None Typical Low $812.83 Median $3,890.45 Typical High $14,454.40 | Facility | None | $812.83 | $3,890.45 | $14,454.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $707.95 Median $1,548.82 Typical High $4,897.79 | Professional | None | $707.95 | $1,548.82 | $4,897.79 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,445.44 | Professional | None | $676.08 | $676.08 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,187.76 Typical High $3,162.28 | Facility | None | $741.31 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,659.59 | Professional | None | $831.76 | $831.76 | $1,659.59 |
Fallon Health Setting Facility Modifier None Typical Low $660.69 Median $831.76 Typical High $3,311.31 | Facility | None | $660.69 | $831.76 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,000.00 | Professional | None | $741.31 | $851.14 | $1,000.00 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $724.44 Median $1,318.26 Typical High $1,905.46 | Professional | None | $724.44 | $1,318.26 | $1,905.46 |
Mass General Brigham Setting Facility Modifier None Typical Low $812.83 Median $3,890.45 Typical High $14,454.40 | Facility | None | $812.83 | $3,890.45 | $14,454.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $707.95 Median $1,548.82 Typical High $4,897.79 | Professional | None | $707.95 | $1,548.82 | $4,897.79 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $12,022.64 | Facility | None | $1,071.52 | $3,890.45 | $12,022.64 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $2,884.03 | Professional | None | $741.31 | $1,000.00 | $2,884.03 |
Well Sense Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $977.24 | Facility | None | $478.63 | $645.65 | $977.24 |
Well Sense Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $660.69 | Professional | None | $478.63 | $478.63 | $660.69 |
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 $302.00 Median $302.00 Typical High $933.25 | Professional | 52 · Reduced service | $302.00 | $302.00 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $380.19 | Professional | 53 · Discontinued | $120.23 | $120.23 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $1,412.54 | Professional | 54 · Surgery only | $457.09 | $457.09 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $281.84 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $186.21 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $1,318.26 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $912.01 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $537.03 | $912.01 | $1,230.27 |
Where Massachusetts sits
The same service costs 7.6 times more in Oklahoma 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.
Physician feeFacility fee
OK $11,248TX $1,472
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.