How much rates vary
Facilitymedian $603 · 10th to 90th $209 to $3,548Professionalmedian $490 · 10th to 90th $309 to $2,951
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 $331.13 Median $331.13 Typical High $758.58 | Professional | None | $331.13 | $331.13 | $758.58 |
AllWays Health Partners Setting Facility Modifier None Typical Low $251.19 Median $870.96 Typical High $3,801.89 | Facility | None | $251.19 | $870.96 | $3,801.89 |
AllWays Health Partners Setting Professional Modifier None Typical Low $363.08 Median $912.01 Typical High $2,951.21 | Professional | None | $363.08 | $912.01 | $2,951.21 |
BCBS Setting Professional Modifier None Typical Low $338.84 Median $676.08 Typical High $1,071.52 | Professional | None | $338.84 | $676.08 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $954.99 | Facility | None | $50.12 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $1,047.13 | Professional | None | $389.05 | $389.05 | $1,047.13 |
Fallon Health Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $794.33 | Facility | None | $186.21 | $363.08 | $794.33 |
Fallon Health Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $489.78 | Professional | None | $186.21 | $338.84 | $489.78 |
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 $363.08 Median $645.65 Typical High $1,000.00 | Professional | None | $363.08 | $645.65 | $1,000.00 |
Mass General Brigham Setting Facility Modifier None Typical Low $251.19 Median $870.96 Typical High $3,801.89 | Facility | None | $251.19 | $870.96 | $3,801.89 |
Mass General Brigham Setting Professional Modifier None Typical Low $363.08 Median $912.01 Typical High $2,951.21 | Professional | None | $363.08 | $912.01 | $2,951.21 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,258.93 Typical High $5,128.61 | Facility | None | $575.44 | $1,258.93 | $5,128.61 |
United Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $1,258.93 | Professional | None | $380.19 | $489.78 | $1,258.93 |
Well Sense Setting Facility Modifier None Typical Low $363.08 Median $489.78 Typical High $741.31 | Facility | None | $363.08 | $489.78 | $741.31 |
Well Sense Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $436.52 | Professional | None | $363.08 | $363.08 | $436.52 |
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 $165.96 Median $165.96 Typical High $467.74 | Professional | 52 · Reduced service | $165.96 | $165.96 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $190.55 | Professional | 53 · Discontinued | $67.61 | $67.61 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $707.95 | Professional | 54 · Surgery only | $251.19 | $251.19 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $141.25 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $660.69 |
Where Massachusetts sits
The same service costs 5.8 times more in Alaska 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· 25th of 51
$490
AK $1,380UT $240
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.