How much rates vary
Facilitymedian $1,148 · 10th to 90th $490 to $5,129Professionalmedian $1,148 · 10th to 90th $631 to $5,248
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 $1,949.84 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $2,238.72 | Professional | None | $630.96 | $630.96 | $2,238.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $5,623.41 | Facility | None | $602.56 | $1,949.84 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $851.14 Median $2,187.76 Typical High $5,248.07 | Professional | None | $851.14 | $2,187.76 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $1,380.38 | Facility | None | $50.12 | $954.99 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,187.76 | Professional | None | $933.25 | $933.25 | $2,187.76 |
Fallon Health Setting Facility Modifier None Typical Low $457.09 Median $891.25 Typical High $2,691.53 | Facility | None | $457.09 | $891.25 | $2,691.53 |
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 $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,344.23 | Professional | None | $891.25 | $1,621.81 | $2,344.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $5,623.41 | Facility | None | $602.56 | $1,949.84 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $851.14 Median $2,187.76 Typical High $5,248.07 | Professional | None | $851.14 | $2,187.76 | $5,248.07 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $7,244.36 | Facility | None | $851.14 | $2,818.38 | $7,244.36 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $2,818.38 | Professional | None | $870.96 | $1,174.90 | $2,818.38 |
Well Sense Setting Facility Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,778.28 | Facility | None | $851.14 | $1,148.15 | $1,778.28 |
Well Sense Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | None | $851.14 | $851.14 | $1,023.29 |
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 $316.23 Median $316.23 Typical High $1,122.02 | Professional | 52 · Reduced service | $316.23 | $316.23 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $446.68 | Professional | 53 · Discontinued | $125.89 | $125.89 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $1,659.59 | Professional | 54 · Surgery only | $478.63 | $478.63 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $331.13 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $223.87 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $1,548.82 |
Where Massachusetts sits
The same service costs 8.5 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· 24th of 51
$1,148
OK $3,162TX $372
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.