How much rates vary
Facilitymedian $1,047 · 10th to 90th $437 to $4,169Professionalmedian $1,000 · 10th to 90th $513 to $5,012
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 $3,090.30 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $2,089.30 | Professional | None | $707.95 | $707.95 | $2,089.30 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $1,621.81 Typical High $4,265.80 | Facility | None | $457.09 | $1,621.81 | $4,265.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $676.08 Median $1,905.46 Typical High $5,011.87 | Professional | None | $676.08 | $1,905.46 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,380.38 Typical High $1,949.84 | Facility | None | $741.31 | $1,380.38 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,290.87 | Professional | None | $933.25 | $933.25 | $2,290.87 |
Fallon Health Setting Facility Modifier None Typical Low $389.05 Median $758.58 Typical High $1,348.96 | Facility | None | $389.05 | $758.58 | $1,348.96 |
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 $758.58 Median $1,380.38 Typical High $2,454.71 | Professional | None | $758.58 | $1,380.38 | $2,454.71 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $1,621.81 Typical High $4,265.80 | Facility | None | $457.09 | $1,621.81 | $4,265.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $676.08 Median $1,905.46 Typical High $5,011.87 | Professional | None | $676.08 | $1,905.46 | $5,011.87 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,413.10 | Facility | None | $1,047.13 | $2,344.23 | $7,413.10 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $2,818.38 | Professional | None | $741.31 | $1,047.13 | $2,818.38 |
Well Sense Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $1,047.13 | Facility | None | $562.34 | $676.08 | $1,047.13 |
Well Sense Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $630.96 | Professional | None | $524.81 | $524.81 | $630.96 |
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 $354.81 Median $354.81 Typical High $1,047.13 | Professional | 52 · Reduced service | $354.81 | $354.81 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $416.87 | Professional | 53 · Discontinued | $141.25 | $141.25 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $1,548.82 | Professional | 54 · Surgery only | $524.81 | $524.81 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $309.03 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $208.93 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,445.44 |
Where Massachusetts sits
The same service costs 6.0 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
$1,000
OK $2,884UT $479
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.