How much rates vary
Facilitymedian $2,818 · 10th to 90th $708 to $6,310Professionalmedian $1,122 · 10th to 90th $575 to $6,026
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 $1,949.84 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,235.94 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | None | $575.44 | $575.44 | $616.60 |
AllWays Health Partners Setting Facility Modifier None Typical Low $645.65 Median $2,884.03 Typical High $8,128.31 | Facility | None | $645.65 | $2,884.03 | $8,128.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $645.65 Median $1,584.89 Typical High $6,025.60 | Professional | None | $645.65 | $1,584.89 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $3,311.31 | Facility | None | $831.76 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,862.09 | Professional | None | $758.58 | $758.58 | $1,862.09 |
Fallon Health Setting Facility Modifier None Typical Low $707.95 Median $831.76 Typical High $5,888.44 | Facility | None | $707.95 | $831.76 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | None | $707.95 | $707.95 | $831.76 |
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 $616.60 Median $1,202.26 Typical High $2,344.23 | Professional | None | $616.60 | $1,202.26 | $2,344.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $645.65 Median $2,884.03 Typical High $8,128.31 | Facility | None | $645.65 | $2,884.03 | $8,128.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $645.65 Median $1,584.89 Typical High $6,025.60 | Professional | None | $645.65 | $1,584.89 | $6,025.60 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,174.90 Typical High $2,630.27 | Professional | None | $724.44 | $1,174.90 | $2,630.27 |
Well Sense Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $4,365.16 | Facility | None | $1,174.90 | $3,090.30 | $4,365.16 |
7 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 $281.84 Median $281.84 Typical High $288.40 | Professional | 52 · Reduced service | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $398.11 |
Well Sense Setting Professional Modifier 58 · Staged procedure + 76 · Repeat, same provider + 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Professional | 58 · Staged procedure + 76 · Repeat, same provider + 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $2,398.83 |
Where Massachusetts sits
The same service costs 7.4 times more in Oklahoma than in New York. 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· 19th of 51
$1,318
OK $3,802NY $513
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.