How much rates vary
Facilitymedian $1,047 · 10th to 90th $251 to $4,266Professionalmedian $537 · 10th to 90th $339 to $2,884
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 $371.54 Median $371.54 Typical High $1,023.29 | Professional | None | $371.54 | $371.54 | $1,023.29 |
AllWays Health Partners Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $4,897.79 | Facility | None | $512.86 | $1,737.80 | $4,897.79 |
AllWays Health Partners Setting Professional Modifier None Typical Low $398.11 Median $1,000.00 Typical High $2,884.03 | Professional | None | $398.11 | $1,000.00 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,290.87 Typical High $3,388.44 | Facility | None | $954.99 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,148.15 | Professional | None | $436.52 | $436.52 | $1,148.15 |
Fallon Health Setting Facility Modifier None Typical Low $213.80 Median $407.38 Typical High $2,691.53 | Facility | None | $213.80 | $407.38 | $2,691.53 |
Fallon Health Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $537.03 | Professional | None | $204.17 | $371.54 | $537.03 |
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 $398.11 Median $741.31 Typical High $1,412.54 | Professional | None | $398.11 | $741.31 | $1,412.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $4,897.79 | Facility | None | $512.86 | $1,737.80 | $4,897.79 |
Mass General Brigham Setting Professional Modifier None Typical Low $398.11 Median $1,000.00 Typical High $2,884.03 | Professional | None | $398.11 | $1,000.00 | $2,884.03 |
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 $416.87 Median $537.03 Typical High $1,412.54 | Professional | None | $416.87 | $537.03 | $1,412.54 |
Well Sense Setting Facility Modifier None Typical Low $436.52 Median $691.83 Typical High $1,230.27 | Facility | None | $436.52 | $691.83 | $1,230.27 |
Well Sense Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | None | $398.11 | $398.11 | $478.63 |
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 $186.21 Median $186.21 Typical High $512.86 | Professional | 52 · Reduced service | $186.21 | $186.21 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $208.93 | Professional | 53 · Discontinued | $74.13 | $74.13 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $776.25 | Professional | 54 · Surgery only | $275.42 | $275.42 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $154.88 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $102.33 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $724.44 |
Where Massachusetts sits
The same service costs 7.1 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· 27th of 51
$562
OK $1,950UT $275
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.