How much rates vary
Facilitymedian $1,622 · 10th to 90th $562 to $6,457Professionalmedian $1,380 · 10th to 90th $692 to $6,918
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 $954.99 Median $954.99 Typical High $2,137.96 | Professional | None | $954.99 | $954.99 | $2,137.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $575.44 Median $2,630.27 Typical High $8,128.31 | Facility | None | $575.44 | $2,630.27 | $8,128.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $912.01 Median $2,570.40 Typical High $6,918.31 | Professional | None | $912.01 | $2,570.40 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $6,309.57 Typical High $9,549.93 | Facility | None | $446.68 | $6,309.57 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $3,162.28 | Professional | None | $1,258.93 | $1,258.93 | $3,162.28 |
Fallon Health Setting Facility Modifier None Typical Low $537.03 Median $1,047.13 Typical High $2,818.38 | Facility | None | $537.03 | $1,047.13 | $2,818.38 |
Fallon Health Setting Professional Modifier None Typical Low $524.81 Median $954.99 Typical High $1,380.38 | Professional | None | $524.81 | $954.99 | $1,380.38 |
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 $1,023.29 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,023.29 | $1,862.09 | $3,311.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $575.44 Median $2,630.27 Typical High $8,128.31 | Facility | None | $575.44 | $2,630.27 | $8,128.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $912.01 Median $2,570.40 Typical High $6,918.31 | Professional | None | $912.01 | $2,570.40 | $6,918.31 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $14,125.38 | Facility | None | $851.14 | $2,818.38 | $14,125.38 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $3,801.89 | Professional | None | $1,047.13 | $1,479.11 | $3,801.89 |
Well Sense Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
Well Sense Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | None | $741.31 | $741.31 | $891.25 |
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 $478.63 Median $478.63 Typical High $1,513.56 | Professional | 52 · Reduced service | $478.63 | $478.63 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $616.60 | Professional | 53 · Discontinued | $190.55 | $190.55 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $2,290.87 | Professional | 54 · Surgery only | $707.95 | $707.95 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $457.09 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $302.00 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $2,137.96 |
Where Massachusetts sits
The same service costs 6.3 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
$1,380
OK $4,169UT $661
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.