How much rates vary
Facilitymedian $1,175 · 10th to 90th $302 to $6,166Professionalmedian $646 · 10th to 90th $331 to $2,951
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 $1,348.96 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,348.96 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,000.00 | Professional | None | $436.52 | $436.52 | $1,000.00 |
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 $426.58 Median $1,202.26 Typical High $2,951.21 | Professional | None | $426.58 | $1,202.26 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,265.80 Typical High $6,456.54 | Facility | None | $831.76 | $4,265.80 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,445.44 | Professional | None | $588.84 | $588.84 | $1,445.44 |
Fallon Health Setting Facility Modifier None Typical Low $257.04 Median $501.19 Typical High $2,691.53 | Facility | None | $257.04 | $501.19 | $2,691.53 |
Fallon Health Setting Professional Modifier None Typical Low $245.47 Median $446.68 Typical High $645.65 | Professional | None | $245.47 | $446.68 | $645.65 |
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 $478.63 Median $891.25 Typical High $1,548.82 | Professional | None | $478.63 | $891.25 | $1,548.82 |
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 $426.58 Median $1,202.26 Typical High $2,951.21 | Professional | None | $426.58 | $1,202.26 | $2,951.21 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $12,302.69 | Facility | None | $851.14 | $2,818.38 | $12,302.69 |
United Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,778.28 | Professional | None | $457.09 | $660.69 | $1,778.28 |
Well Sense Setting Facility Modifier None Typical Low $354.81 Median $630.96 Typical High $1,174.90 | Facility | None | $354.81 | $630.96 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $398.11 | Professional | None | $331.13 | $331.13 | $398.11 |
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 $218.78 Median $218.78 Typical High $676.08 | Professional | 52 · Reduced service | $218.78 | $218.78 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $269.15 | Professional | 53 · Discontinued | $87.10 | $87.10 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $1,000.00 | Professional | 54 · Surgery only | $331.13 | $331.13 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $199.53 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $134.90 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $933.25 |
Where Massachusetts sits
The same service costs 9.8 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· 23rd of 51
$692
OK $3,236UT $331
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.