How much rates vary
Facilitymedian $1,072 · 10th to 90th $513 to $5,248Professionalmedian $1,202 · 10th to 90th $603 to $7,586
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 $3,090.30 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $2,511.89 | Professional | None | $851.14 | $851.14 | $2,511.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $6,165.95 | Facility | None | $602.56 | $1,995.26 | $6,165.95 |
AllWays Health Partners Setting Professional Modifier None Typical Low $794.33 Median $2,187.76 Typical High $7,585.78 | Professional | None | $794.33 | $2,187.76 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $831.76 Typical High $954.99 | Facility | None | $50.12 | $831.76 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,122.02 | $2,754.23 |
Fallon Health Setting Facility Modifier None Typical Low $478.63 Median $912.01 Typical High $2,691.53 | Facility | None | $478.63 | $912.01 | $2,691.53 |
Fallon Health Setting Professional Modifier None Typical Low $467.74 Median $831.76 Typical High $1,202.26 | Professional | None | $467.74 | $831.76 | $1,202.26 |
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 $891.25 Median $1,659.59 Typical High $2,818.38 | Professional | None | $891.25 | $1,659.59 | $2,818.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $6,165.95 | Facility | None | $602.56 | $1,995.26 | $6,165.95 |
Mass General Brigham Setting Professional Modifier None Typical Low $794.33 Median $2,187.76 Typical High $7,585.78 | Professional | None | $794.33 | $2,187.76 | $7,585.78 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $7,244.36 | Facility | None | $851.14 | $2,290.87 | $7,244.36 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $3,715.35 | Professional | None | $891.25 | $1,230.27 | $3,715.35 |
Well Sense Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $1,258.93 | Facility | None | $602.56 | $812.83 | $1,258.93 |
Well Sense Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | None | $630.96 | $630.96 | $758.58 |
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 $426.58 Median $426.58 Typical High $1,258.93 | Professional | 52 · Reduced service | $426.58 | $426.58 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $512.86 | Professional | 53 · Discontinued | $173.78 | $173.78 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $1,905.46 | Professional | 54 · Surgery only | $645.65 | $645.65 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $380.19 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $251.19 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $1,778.28 |
Where Massachusetts sits
The same service costs 6.2 times more in Oklahoma than in Utah. 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· 26th of 51
$1,202
OK $3,631UT $589
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.