How much rates vary
Facilitymedian $288 · 10th to 90th $100 to $3,715Professionalmedian $275 · 10th to 90th $158 to $2,042
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 $190.55 Median $2,137.96 Typical High $3,388.44 | Facility | None | $190.55 | $2,137.96 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $478.63 | Professional | None | $169.82 | $190.55 | $478.63 |
AllWays Health Partners Setting Facility Modifier None Typical Low $389.05 Median $1,380.38 Typical High $4,265.80 | Facility | None | $389.05 | $1,380.38 | $4,265.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $169.82 Median $407.38 Typical High $2,041.74 | Professional | None | $169.82 | $407.38 | $2,041.74 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $165.96 Median $199.53 Typical High $380.19 | Facility | None | $165.96 | $199.53 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $190.55 Typical High $831.76 | Facility | None | $134.90 | $190.55 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $575.44 | Professional | None | $229.09 | $263.03 | $575.44 |
Fallon Health Setting Facility Modifier None Typical Low $95.50 Median $190.55 Typical High $1,905.46 | Facility | None | $95.50 | $190.55 | $1,905.46 |
Fallon Health Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $309.03 | Professional | None | $120.23 | $213.80 | $309.03 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $181.97 Median $354.81 Typical High $630.96 | Professional | None | $181.97 | $354.81 | $630.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $389.05 Median $1,380.38 Typical High $4,265.80 | Facility | None | $389.05 | $1,380.38 | $4,265.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $169.82 Median $407.38 Typical High $2,041.74 | Professional | None | $169.82 | $407.38 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,413.10 | Facility | None | $1,047.13 | $2,344.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $741.31 | Professional | None | $186.21 | $275.42 | $741.31 |
Well Sense Setting Facility Modifier None Typical Low $69.18 Median $165.96 Typical High $288.40 | Facility | None | $69.18 | $165.96 | $288.40 |
Well Sense Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $165.96 | Professional | None | $123.03 | $138.04 | $165.96 |
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 $85.11 Median $95.50 Typical High $239.88 | Professional | 52 · Reduced service | $85.11 | $95.50 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.90 Typical High $95.50 | Professional | 53 · Discontinued | $33.88 | $38.90 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $144.54 Typical High $354.81 | Professional | 54 · Surgery only | $128.82 | $144.54 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $28.84 Typical High $72.44 | Professional | 55 · Aftercare only | $25.70 | $28.84 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.05 Typical High $47.86 | Professional | 56 · Pre-op care only | $16.98 | $19.05 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $134.90 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $120.23 | $134.90 | $331.13 |
Where Massachusetts sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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· 18th of 51
$275
OK $891FL $182
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.