How much rates vary
Facilitymedian $2,884 · 10th to 90th $347 to $12,023Professionalmedian $525 · 10th to 90th $309 to $2,188
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 $2,089.30 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,089.30 | $3,019.95 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $371.54 | Professional | None | $234.42 | $234.42 | $371.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $954.99 Median $5,128.61 Typical High $16,218.10 | Facility | None | $954.99 | $5,128.61 | $16,218.10 |
AllWays Health Partners Setting Professional Modifier None Typical Low $323.59 Median $794.33 Typical High $2,187.76 | Professional | None | $323.59 | $794.33 | $2,187.76 |
BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,348.96 Typical High $1,348.96 | Professional | None | $758.58 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $10,000.00 Typical High $12,882.50 | Facility | None | $676.08 | $10,000.00 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $912.01 | Professional | None | $524.81 | $524.81 | $912.01 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $407.38 Typical High $3,311.31 | Facility | None | $177.83 | $407.38 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $501.19 | Professional | None | $354.81 | $407.38 | $501.19 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $20,892.96 | Facility | None | $1,096.48 | $4,073.80 | $20,892.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $363.08 Median $691.83 Typical High $1,479.11 | Professional | None | $363.08 | $691.83 | $1,479.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $954.99 Median $5,128.61 Typical High $16,218.10 | Facility | None | $954.99 | $5,128.61 | $16,218.10 |
Mass General Brigham Setting Professional Modifier None Typical Low $323.59 Median $794.33 Typical High $2,187.76 | Professional | None | $323.59 | $794.33 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $32,359.37 | Facility | None | $1,258.93 | $4,073.80 | $32,359.37 |
United Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $1,479.11 | Professional | None | $416.87 | $562.34 | $1,479.11 |
Well Sense Setting Facility Modifier None Typical Low $275.42 Median $436.52 Typical High $5,128.61 | Facility | None | $275.42 | $436.52 | $5,128.61 |
Well Sense Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | None | $263.03 | $263.03 | $309.03 |
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 $114.82 Median $114.82 Typical High $186.21 | Professional | 52 · Reduced service | $114.82 | $114.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $74.13 | Professional | 53 · Discontinued | $46.77 | $46.77 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $281.84 | Professional | 54 · Surgery only | $173.78 | $173.78 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $56.23 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $37.15 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $263.03 |
Where Massachusetts sits
The same service costs 21.5 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 $21,837MT $1,015
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.