How much rates vary
Facilitymedian $933 · 10th to 90th $229 to $4,266Professionalmedian $490 · 10th to 90th $251 to $3,388
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 $1,023.29 Median $2,818.38 Typical High $5,248.07 | Facility | None | $1,023.29 | $2,818.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $741.31 | Professional | None | $323.59 | $323.59 | $741.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $4,265.80 | Facility | None | $602.56 | $1,445.44 | $4,265.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $323.59 Median $912.01 Typical High $3,388.44 | Professional | None | $323.59 | $912.01 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,348.96 Typical High $1,949.84 | Facility | None | $831.76 | $1,348.96 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $1,071.52 | Professional | None | $446.68 | $446.68 | $1,071.52 |
Fallon Health Setting Facility Modifier None Typical Low $190.55 Median $371.54 Typical High $2,691.53 | Facility | None | $190.55 | $371.54 | $2,691.53 |
Fallon Health Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $478.63 | Professional | None | $186.21 | $331.13 | $478.63 |
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 $363.08 Median $660.69 Typical High $1,148.15 | Professional | None | $363.08 | $660.69 | $1,148.15 |
Health New England Setting Facility Modifier None Typical Low $1,096.48 Median $3,890.45 Typical High $6,025.60 | Facility | None | $1,096.48 | $3,890.45 | $6,025.60 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $4,265.80 | Facility | None | $602.56 | $1,445.44 | $4,265.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $323.59 Median $912.01 Typical High $3,388.44 | Professional | None | $323.59 | $912.01 | $3,388.44 |
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 $346.74 Median $501.19 Typical High $1,348.96 | Professional | None | $346.74 | $501.19 | $1,348.96 |
Well Sense Setting Facility Modifier None Typical Low $263.03 Median $478.63 Typical High $691.83 | Facility | None | $263.03 | $478.63 | $691.83 |
Well Sense Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $302.00 | Professional | None | $251.19 | $251.19 | $302.00 |
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 $162.18 Median $162.18 Typical High $512.86 | Professional | 52 · Reduced service | $162.18 | $162.18 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $204.17 | Professional | 53 · Discontinued | $64.57 | $64.57 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $776.25 | Professional | 54 · Surgery only | $245.47 | $245.47 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $154.88 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $102.33 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $724.44 |
Where Massachusetts sits
The same service costs 5.1 times more in Oklahoma than in Montana. 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 $5,094MT $991
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.