How much rates vary
Facilitymedian $1,175 · 10th to 90th $447 to $3,981Professionalmedian $955 · 10th to 90th $501 to $4,169
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 $1,548.82 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,548.82 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,071.52 | Professional | None | $691.83 | $691.83 | $1,071.52 |
AllWays Health Partners Setting Facility Modifier None Typical Low $954.99 Median $1,621.81 Typical High $4,265.80 | Facility | None | $954.99 | $1,621.81 | $4,265.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $660.69 Median $1,621.81 Typical High $4,677.35 | Professional | None | $660.69 | $1,621.81 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,691.53 Typical High $3,467.37 | Facility | None | $676.08 | $2,691.53 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,238.72 | Professional | None | $933.25 | $933.25 | $2,238.72 |
Fallon Health Setting Facility Modifier None Typical Low $398.11 Median $758.58 Typical High $2,187.76 | Facility | None | $398.11 | $758.58 | $2,187.76 |
Fallon Health Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $1,000.00 | Professional | None | $389.05 | $691.83 | $1,000.00 |
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 $741.31 Median $1,380.38 Typical High $2,398.83 | Professional | None | $741.31 | $1,380.38 | $2,398.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $954.99 Median $1,621.81 Typical High $4,265.80 | Facility | None | $954.99 | $1,621.81 | $4,265.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $660.69 Median $1,621.81 Typical High $4,677.35 | Professional | None | $660.69 | $1,621.81 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,332.54 | Facility | None | $1,047.13 | $2,344.23 | $9,332.54 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $2,818.38 | Professional | None | $758.58 | $1,047.13 | $2,818.38 |
Well Sense Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $1,174.90 | Facility | None | $549.54 | $1,000.00 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $562.34 | Professional | None | $467.74 | $467.74 | $562.34 |
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 $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | 54 · Surgery only | $512.86 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $489.78 |
Where Massachusetts sits
The same service costs 4.2 times more in Oklahoma than in Kentucky. 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 $7,369KY $1,773
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.