How much rates vary
Facilitymedian $2,089 · 10th to 90th $708 to $9,120Professionalmedian $1,585 · 10th to 90th $832 to $8,913
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 $2,691.53 Median $3,388.44 Typical High $8,709.64 | Facility | None | $2,691.53 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $3,235.94 | Professional | None | $1,148.15 | $1,148.15 | $3,235.94 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,174.90 Median $3,890.45 Typical High $13,182.57 | Facility | None | $1,174.90 | $3,890.45 | $13,182.57 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,174.90 Median $2,951.21 Typical High $8,912.51 | Professional | None | $1,174.90 | $2,951.21 | $8,912.51 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $7,762.47 Typical High $10,000.00 | Facility | None | $954.99 | $7,762.47 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $3,467.37 | Professional | None | $1,288.25 | $1,288.25 | $3,467.37 |
Fallon Health Setting Facility Modifier None Typical Low $602.56 Median $1,174.90 Typical High $1,995.26 | Facility | None | $602.56 | $1,174.90 | $1,995.26 |
Fallon Health Setting Professional Modifier None Typical Low $602.56 Median $1,096.48 Typical High $1,584.89 | Professional | None | $602.56 | $1,096.48 | $1,584.89 |
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 $1,202.26 Median $2,187.76 Typical High $4,265.80 | Professional | None | $1,202.26 | $2,187.76 | $4,265.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,174.90 Median $3,890.45 Typical High $13,182.57 | Facility | None | $1,174.90 | $3,890.45 | $13,182.57 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,174.90 Median $2,951.21 Typical High $8,912.51 | Professional | None | $1,174.90 | $2,951.21 | $8,912.51 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,982.44 | Facility | None | $1,071.52 | $3,890.45 | $16,982.44 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $4,265.80 | Professional | None | $1,258.93 | $1,659.59 | $4,265.80 |
Well Sense Setting Facility Modifier None Typical Low $912.01 Median $1,659.59 Typical High $3,019.95 | Facility | None | $912.01 | $1,659.59 | $3,019.95 |
Well Sense Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | None | $812.83 | $812.83 | $977.24 |
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 $562.34 Median $562.34 Typical High $1,584.89 | Professional | 52 · Reduced service | $562.34 | $562.34 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $645.65 | Professional | 53 · Discontinued | $229.09 | $229.09 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $2,398.83 | Professional | 54 · Surgery only | $851.14 | $851.14 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $478.63 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $323.59 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $2,238.72 |
Where Massachusetts sits
The same service costs 8.7 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· 27th of 51
$1,622
OK $6,166TX $708
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.