How much rates vary
Facilitymedian $1,380 · 10th to 90th $468 to $5,495Professionalmedian $1,148 · 10th to 90th $575 to $5,370
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 $1,318.26 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,454.71 | Professional | None | $812.83 | $812.83 | $2,454.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $489.78 Median $2,290.87 Typical High $6,606.93 | Facility | None | $489.78 | $2,290.87 | $6,606.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $776.25 Median $2,137.96 Typical High $5,370.32 | Professional | None | $776.25 | $2,137.96 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $3,467.37 Typical High $5,248.07 | Facility | None | $446.68 | $3,467.37 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,071.52 | $2,630.27 |
Fallon Health Setting Facility Modifier None Typical Low $446.68 Median $870.96 Typical High $1,778.28 | Facility | None | $446.68 | $870.96 | $1,778.28 |
Fallon Health Setting Professional Modifier None Typical Low $446.68 Median $794.33 Typical High $1,148.15 | Professional | None | $446.68 | $794.33 | $1,148.15 |
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 $870.96 Median $1,584.89 Typical High $3,162.28 | Professional | None | $870.96 | $1,584.89 | $3,162.28 |
Mass General Brigham Setting Facility Modifier None Typical Low $489.78 Median $2,290.87 Typical High $6,606.93 | Facility | None | $489.78 | $2,290.87 | $6,606.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $776.25 Median $2,137.96 Typical High $5,370.32 | Professional | None | $776.25 | $2,137.96 | $5,370.32 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $12,302.69 | Facility | None | $851.14 | $2,818.38 | $12,302.69 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $3,467.37 | Professional | None | $812.83 | $1,148.15 | $3,467.37 |
Well Sense Setting Facility Modifier None Typical Low $630.96 Median $870.96 Typical High $1,698.24 | Facility | None | $630.96 | $870.96 | $1,698.24 |
Well Sense Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | None | $602.56 | $602.56 | $724.44 |
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 $407.38 Median $407.38 Typical High $1,202.26 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $489.78 | Professional | 53 · Discontinued | $162.18 | $162.18 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $1,819.70 | Professional | 54 · Surgery only | $602.56 | $602.56 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $363.08 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $245.47 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $1,698.24 |
Where Massachusetts sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $1,932
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.