How much rates vary
Facilitymedian $2,042 · 10th to 90th $513 to $9,120Professionalmedian $1,148 · 10th to 90th $603 to $5,370
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 $6,309.57 | Facility | None | $2,691.53 | $3,388.44 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $870.96 | Professional | None | $831.76 | $851.14 | $870.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $15,488.17 | Facility | None | $1,071.52 | $4,265.80 | $15,488.17 |
AllWays Health Partners Setting Professional Modifier None Typical Low $758.58 Median $1,819.70 Typical High $5,370.32 | Professional | None | $758.58 | $1,819.70 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $7,762.47 Typical High $10,000.00 | Facility | None | $676.08 | $7,762.47 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,511.89 | Professional | None | $933.25 | $933.25 | $2,511.89 |
Fallon Health Setting Facility Modifier None Typical Low $457.09 Median $891.25 Typical High $2,951.21 | Facility | None | $457.09 | $891.25 | $2,951.21 |
Fallon Health Setting Professional Modifier None Typical Low $446.68 Median $794.33 Typical High $1,148.15 | Professional | None | $446.68 | $794.33 | $1,148.15 |
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 $870.96 Median $1,584.89 Typical High $3,090.30 | Professional | None | $870.96 | $1,584.89 | $3,090.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $15,488.17 | Facility | None | $1,071.52 | $4,265.80 | $15,488.17 |
Mass General Brigham Setting Professional Modifier None Typical Low $758.58 Median $1,819.70 Typical High $5,370.32 | Professional | None | $758.58 | $1,819.70 | $5,370.32 |
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 $912.01 Median $1,258.93 Typical High $3,090.30 | Professional | None | $912.01 | $1,258.93 | $3,090.30 |
Well Sense Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $4,168.69 | Facility | None | $660.69 | $1,202.26 | $4,168.69 |
Well Sense Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | None | $549.54 | $549.54 | $660.69 |
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 $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Where Massachusetts sits
The same service costs 11.0 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· 26th of 51
$1,148
OK $5,888UT $537
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.