How much rates vary
Facilitymedian $1,047 · 10th to 90th $275 to $4,571Professionalmedian $617 · 10th to 90th $324 to $3,981
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 $1,778.28 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,778.28 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $891.25 | Professional | None | $407.38 | $407.38 | $891.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $4,897.79 | Facility | None | $602.56 | $1,737.80 | $4,897.79 |
AllWays Health Partners Setting Professional Modifier None Typical Low $436.52 Median $1,174.90 Typical High $3,981.07 | Professional | None | $436.52 | $1,174.90 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,290.87 Typical High $3,311.31 | Facility | None | $741.31 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,318.26 | Professional | None | $501.19 | $501.19 | $1,318.26 |
Fallon Health Setting Facility Modifier None Typical Low $245.47 Median $478.63 Typical High $2,691.53 | Facility | None | $245.47 | $478.63 | $2,691.53 |
Fallon Health Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $616.60 | Professional | None | $234.42 | $426.58 | $616.60 |
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 $457.09 Median $831.76 Typical High $1,584.89 | Professional | None | $457.09 | $831.76 | $1,584.89 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $4,897.79 | Facility | None | $602.56 | $1,737.80 | $4,897.79 |
Mass General Brigham Setting Professional Modifier None Typical Low $436.52 Median $1,174.90 Typical High $3,981.07 | Professional | None | $436.52 | $1,174.90 | $3,981.07 |
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 $478.63 Median $616.60 Typical High $1,584.89 | Professional | None | $478.63 | $616.60 | $1,584.89 |
Well Sense Setting Facility Modifier None Typical Low $354.81 Median $562.34 Typical High $1,230.27 | Facility | None | $354.81 | $562.34 | $1,230.27 |
Well Sense Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | None | $295.12 | $295.12 | $354.81 |
7 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 $204.17 Median $204.17 Typical High $575.44 | Professional | 52 · Reduced service | $204.17 | $204.17 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $229.09 | Professional | 53 · Discontinued | $81.28 | $81.28 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $870.96 | Professional | 54 · Surgery only | $309.03 | $309.03 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $173.78 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $114.82 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $812.83 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $177.83 Typical High $218.78 | Professional | 80 · Assistant surgeon | $69.18 | $177.83 | $218.78 |
Where Massachusetts sits
The same service costs 10.2 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
$631
OK $2,951UT $288
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.