How much rates vary
Facilitymedian $1,862 · 10th to 90th $302 to $7,244Professionalmedian $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 $2,570.40 Median $3,467.37 Typical High $7,413.10 | Facility | None | $2,570.40 | $3,467.37 | $7,413.10 |
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 $1,071.52 Median $3,467.37 Typical High $9,772.37 | Facility | None | $1,071.52 | $3,467.37 | $9,772.37 |
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 $3,981.07 Typical High $5,888.44 | Facility | None | $831.76 | $3,981.07 | $5,888.44 |
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 $489.78 Typical High $2,818.38 | Facility | None | $257.04 | $489.78 | $2,818.38 |
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 $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $478.63 Median $870.96 Typical High $1,548.82 | Professional | None | $478.63 | $870.96 | $1,548.82 |
Health New England Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Facility | None | $8,128.31 | $8,128.31 | $8,128.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $9,772.37 | Facility | None | $1,071.52 | $3,467.37 | $9,772.37 |
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 $1,071.52 Median $3,890.45 Typical High $15,488.17 | Facility | None | $1,071.52 | $3,890.45 | $15,488.17 |
United Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $1,778.28 | Professional | None | $446.68 | $660.69 | $1,778.28 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $562.34 Typical High $1,862.09 | Facility | None | $346.74 | $562.34 | $1,862.09 |
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 $660.69 | Professional | 52 · Reduced service | $218.78 | $218.78 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $263.03 | Professional | 53 · Discontinued | $87.10 | $87.10 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $1,000.00 | Professional | 54 · Surgery only | $323.59 | $323.59 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $199.53 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $131.83 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $933.25 |
Where Massachusetts sits
The same service costs 9.5 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· 21st of 51
$708
OK $3,236UT $339
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.