How much rates vary
Facilitymedian $1,047 · 10th to 90th $191 to $4,266Professionalmedian $407 · 10th to 90th $219 to $2,089
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $794.33 | Professional | None | $281.84 | $281.84 | $794.33 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $1,737.80 Typical High $4,897.79 | Facility | None | $724.44 | $1,737.80 | $4,897.79 |
AllWays Health Partners Setting Professional Modifier None Typical Low $295.12 Median $776.25 Typical High $2,089.30 | Professional | None | $295.12 | $776.25 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,290.87 Typical High $3,311.31 | Facility | None | $446.68 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $891.25 | Professional | None | $338.84 | $338.84 | $891.25 |
Fallon Health Setting Facility Modifier None Typical Low $162.18 Median $316.23 Typical High $1,412.54 | Facility | None | $162.18 | $316.23 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $407.38 | Professional | None | $158.49 | $281.84 | $407.38 |
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 $309.03 Median $562.34 Typical High $1,096.48 | Professional | None | $309.03 | $562.34 | $1,096.48 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $1,737.80 Typical High $4,897.79 | Facility | None | $724.44 | $1,737.80 | $4,897.79 |
Mass General Brigham Setting Professional Modifier None Typical Low $295.12 Median $776.25 Typical High $2,089.30 | Professional | None | $295.12 | $776.25 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $1,096.48 | Professional | None | $323.59 | $426.58 | $1,096.48 |
Well Sense Setting Facility Modifier None Typical Low $239.88 Median $380.19 Typical High $1,047.13 | Facility | None | $239.88 | $380.19 | $1,047.13 |
Well Sense Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $245.47 | Professional | None | $204.17 | $204.17 | $245.47 |
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 $141.25 Median $141.25 Typical High $398.11 | Professional | 52 · Reduced service | $141.25 | $141.25 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $158.49 | Professional | 53 · Discontinued | $56.23 | $56.23 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $588.84 | Professional | 54 · Surgery only | $208.93 | $208.93 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $117.49 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $549.54 |
Where Massachusetts sits
The same service costs 6.0 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· 30th of 51
$437
OK $1,479UT $245
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.