How much rates vary
Facilitymedian $1,479 · 10th to 90th $490 to $6,607Professionalmedian $1,122 · 10th to 90th $575 to $6,026
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 $2,290.87 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,290.87 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $2,290.87 | Professional | None | $758.58 | $758.58 | $2,290.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $933.25 Median $2,818.38 Typical High $9,549.93 | Facility | None | $933.25 | $2,818.38 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $794.33 Median $2,089.30 Typical High $6,025.60 | Professional | None | $794.33 | $2,089.30 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $4,073.80 Typical High $6,165.95 | Facility | None | $446.68 | $4,073.80 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $2,398.83 | Professional | None | $891.25 | $891.25 | $2,398.83 |
Fallon Health Setting Facility Modifier None Typical Low $436.52 Median $851.14 Typical High $2,187.76 | Facility | None | $436.52 | $851.14 | $2,187.76 |
Fallon Health Setting Professional Modifier None Typical Low $426.58 Median $776.25 Typical High $1,122.02 | Professional | None | $426.58 | $776.25 | $1,122.02 |
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 $831.76 Median $1,513.56 Typical High $2,884.03 | Professional | None | $831.76 | $1,513.56 | $2,884.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $933.25 Median $2,818.38 Typical High $9,549.93 | Facility | None | $933.25 | $2,818.38 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $794.33 Median $2,089.30 Typical High $6,025.60 | Professional | None | $794.33 | $2,089.30 | $6,025.60 |
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 $851.14 Median $1,122.02 Typical High $2,884.03 | Professional | None | $851.14 | $1,122.02 | $2,884.03 |
Well Sense Setting Facility Modifier None Typical Low $562.34 Median $794.33 Typical High $1,174.90 | Facility | None | $562.34 | $794.33 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | None | $562.34 | $562.34 | $676.08 |
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 $380.19 Median $380.19 Typical High $1,148.15 | Professional | 52 · Reduced service | $380.19 | $380.19 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $457.09 | Professional | 53 · Discontinued | $151.36 | $151.36 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $1,698.24 | Professional | 54 · Surgery only | $562.34 | $562.34 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $338.84 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $229.09 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $1,584.89 |
Where Massachusetts sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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· 25th of 51
$1,122
OK $3,548TX $525
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.