How much rates vary
Facilitymedian $1,175 · 10th to 90th $490 to $5,370Professionalmedian $1,096 · 10th to 90th $562 to $5,623
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 $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,513.56 | Professional | None | $758.58 | $758.58 | $1,513.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $588.84 Median $1,949.84 Typical High $5,888.44 | Facility | None | $588.84 | $1,949.84 | $5,888.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $724.44 Median $2,041.74 Typical High $5,623.41 | Professional | None | $724.44 | $2,041.74 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,290.87 Typical High $3,311.31 | Facility | None | $446.68 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,000.00 | $2,511.89 |
Fallon Health Setting Facility Modifier None Typical Low $426.58 Median $831.76 Typical High $2,187.76 | Facility | None | $426.58 | $831.76 | $2,187.76 |
Fallon Health Setting Professional Modifier None Typical Low $416.87 Median $758.58 Typical High $1,096.48 | Professional | None | $416.87 | $758.58 | $1,096.48 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $812.83 Median $1,513.56 Typical High $2,630.27 | Professional | None | $812.83 | $1,513.56 | $2,630.27 |
Mass General Brigham Setting Facility Modifier None Typical Low $588.84 Median $1,949.84 Typical High $5,888.44 | Facility | None | $588.84 | $1,949.84 | $5,888.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $724.44 Median $2,041.74 Typical High $5,623.41 | Professional | None | $724.44 | $2,041.74 | $5,623.41 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $10,964.78 | Facility | None | $1,071.52 | $3,467.37 | $10,964.78 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $3,019.95 | Professional | None | $831.76 | $1,148.15 | $3,019.95 |
Well Sense Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $1,288.25 | Facility | None | $602.56 | $870.96 | $1,288.25 |
Well Sense Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | None | $588.84 | $588.84 | $707.95 |
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 $380.19 Median $380.19 Typical High $1,202.26 | Professional | 52 · Reduced service | $380.19 | $380.19 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $478.63 | Professional | 53 · Discontinued | $151.36 | $151.36 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $1,778.28 | Professional | 54 · Surgery only | $562.34 | $562.34 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $354.81 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $239.88 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $1,659.59 |
Where Massachusetts sits
The same service costs 7.9 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· 27th of 51
$1,122
OK $4,169UT $525
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.