How much rates vary
Facilitymedian $2,884 · 10th to 90th $490 to $14,125Professionalmedian $708 · 10th to 90th $417 to $6,918
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 $2,691.53 Median $3,388.44 Typical High $8,709.64 | Facility | None | $2,691.53 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $741.31 | Professional | None | $309.03 | $309.03 | $741.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,096.48 Median $6,165.95 Typical High $21,877.62 | Facility | None | $1,096.48 | $6,165.95 | $21,877.62 |
AllWays Health Partners Setting Professional Modifier None Typical Low $426.58 Median $1,071.52 Typical High $6,918.31 | Professional | None | $426.58 | $1,071.52 | $6,918.31 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $9,772.37 Typical High $14,125.38 | Facility | None | $446.68 | $9,772.37 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,230.27 | Professional | None | $707.95 | $707.95 | $1,230.27 |
Fallon Health Setting Facility Modifier None Typical Low $446.68 Median $562.34 Typical High $3,311.31 | Facility | None | $446.68 | $562.34 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $660.69 | Professional | None | $467.74 | $549.54 | $660.69 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $33,884.42 | Facility | None | $1,096.48 | $4,073.80 | $33,884.42 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $489.78 Median $912.01 Typical High $1,995.26 | Professional | None | $489.78 | $912.01 | $1,995.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,096.48 Median $6,165.95 Typical High $21,877.62 | Facility | None | $1,096.48 | $6,165.95 | $21,877.62 |
Mass General Brigham Setting Professional Modifier None Typical Low $426.58 Median $1,071.52 Typical High $6,918.31 | Professional | None | $426.58 | $1,071.52 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $38,018.94 | Facility | None | $1,258.93 | $4,073.80 | $38,018.94 |
United Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,995.26 | Professional | None | $537.03 | $758.58 | $1,995.26 |
Well Sense Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $6,309.57 | Facility | None | $363.08 | $588.84 | $6,309.57 |
Well Sense Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | None | $363.08 | $363.08 | $426.58 |
6 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 $151.36 Median $151.36 Typical High $707.95 | Professional | 52 · Reduced service | $151.36 | $151.36 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $281.84 | Professional | 53 · Discontinued | $61.66 | $61.66 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $1,071.52 | Professional | 54 · Surgery only | $229.09 | $229.09 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $213.80 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $141.25 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $1,000.00 |
Where Massachusetts sits
The same service costs 16.2 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 $21,968MT $1,353
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.