How much rates vary
Facilitymedian $1,175 · 10th to 90th $339 to $5,248Professionalmedian $724 · 10th to 90th $372 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 $3,090.30 Typical High $5,248.07 | Facility | None | $1,548.82 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,548.82 | Professional | None | $501.19 | $501.19 | $1,548.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $630.96 Median $2,398.83 Typical High $6,606.93 | Facility | None | $630.96 | $2,398.83 | $6,606.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $489.78 Median $1,380.38 Typical High $4,168.69 | Professional | None | $489.78 | $1,380.38 | $4,168.69 |
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 $676.08 Median $676.08 Typical High $1,659.59 | Professional | None | $676.08 | $676.08 | $1,659.59 |
Fallon Health Setting Facility Modifier None Typical Low $288.40 Median $562.34 Typical High $2,691.53 | Facility | None | $288.40 | $562.34 | $2,691.53 |
Fallon Health Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $724.44 | Professional | None | $281.84 | $501.19 | $724.44 |
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 $549.54 Median $1,000.00 Typical High $1,737.80 | Professional | None | $549.54 | $1,000.00 | $1,737.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $630.96 Median $2,398.83 Typical High $6,606.93 | Facility | None | $630.96 | $2,398.83 | $6,606.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $489.78 Median $1,380.38 Typical High $4,168.69 | Professional | None | $489.78 | $1,380.38 | $4,168.69 |
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 $524.81 Median $758.58 Typical High $2,041.74 | Professional | None | $524.81 | $758.58 | $2,041.74 |
Well Sense Setting Facility Modifier None Typical Low $398.11 Median $630.96 Typical High $1,174.90 | Facility | None | $398.11 | $630.96 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | None | $380.19 | $380.19 | $457.09 |
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 $251.19 Median $251.19 Typical High $776.25 | Professional | 52 · Reduced service | $251.19 | $251.19 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $309.03 | Professional | 53 · Discontinued | $100.00 | $100.00 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $1,148.15 | Professional | 54 · Surgery only | $371.54 | $371.54 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $229.09 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $154.88 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $1,071.52 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $69.18 Typical High $79.43 | Professional | 80 · Assistant surgeon | $69.18 | $69.18 | $79.43 |
Where Massachusetts sits
The same service costs 10.0 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
$759
OK $3,631UT $363
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.