How much rates vary
Facilitymedian $617 · 10th to 90th $117 to $3,548Professionalmedian $257 · 10th to 90th $138 to $1,175
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $251.19 | Professional | None | $169.82 | $169.82 | $251.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $436.52 Median $1,071.52 Typical High $3,548.13 | Facility | None | $436.52 | $1,071.52 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $181.97 Median $489.78 Typical High $1,174.90 | Professional | None | $181.97 | $489.78 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,398.83 | Facility | None | $446.68 | $1,659.59 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $562.34 | Professional | None | $213.80 | $213.80 | $562.34 |
Fallon Health Setting Facility Modifier None Typical Low $100.00 Median $186.21 Typical High $346.74 | Facility | None | $100.00 | $186.21 | $346.74 |
Fallon Health Setting Professional Modifier None Typical Low $100.00 Median $177.83 Typical High $257.04 | Professional | None | $100.00 | $177.83 | $257.04 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $676.08 | Professional | None | $194.98 | $354.81 | $676.08 |
Mass General Brigham Setting Facility Modifier None Typical Low $436.52 Median $1,071.52 Typical High $3,548.13 | Facility | None | $436.52 | $1,071.52 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $181.97 Median $489.78 Typical High $1,174.90 | Professional | None | $181.97 | $489.78 | $1,174.90 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $8,709.64 | Facility | None | $575.44 | $1,380.38 | $8,709.64 |
United Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $676.08 | Professional | None | $199.53 | $257.04 | $676.08 |
Well Sense Setting Facility Modifier None Typical Low $147.91 Median $239.88 Typical High $851.14 | Facility | None | $147.91 | $239.88 | $851.14 |
Well Sense Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | None | $123.03 | $123.03 | $147.91 |
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 $85.11 Median $85.11 Typical High $234.42 | Professional | 52 · Reduced service | $85.11 | $85.11 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $95.50 | Professional | 53 · Discontinued | $33.88 | $33.88 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $354.81 | Professional | 54 · Surgery only | $128.82 | $128.82 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $70.79 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $47.86 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $331.13 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $288.40 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $190.55 | $288.40 | $457.09 |
Where Massachusetts sits
The same service costs 8.7 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· 28th of 51
$269
OK $1,349UT $155
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.