How much rates vary
Facilitymedian $575 · 10th to 90th $269 to $3,388Professionalmedian $661 · 10th to 90th $347 to $3,020
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 $354.81 Median $354.81 Typical High $1,230.27 | Professional | None | $354.81 | $354.81 | $1,230.27 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $616.60 Typical High $3,548.13 | Facility | None | $346.74 | $616.60 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $467.74 Median $1,258.93 Typical High $3,019.95 | Professional | None | $467.74 | $1,258.93 | $3,019.95 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $467.74 Median $933.25 Typical High $1,548.82 | Professional | None | $467.74 | $933.25 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $676.08 Typical High $954.99 | Facility | None | $50.12 | $676.08 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,230.27 | Professional | None | $537.03 | $537.03 | $1,230.27 |
Fallon Health Setting Facility Modifier None Typical Low $263.03 Median $512.86 Typical High $2,187.76 | Facility | None | $263.03 | $512.86 | $2,187.76 |
Fallon Health Setting Professional Modifier None Typical Low $257.04 Median $457.09 Typical High $660.69 | Professional | None | $257.04 | $457.09 | $660.69 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $501.19 Median $912.01 Typical High $1,348.96 | Professional | None | $501.19 | $912.01 | $1,348.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $616.60 Typical High $3,548.13 | Facility | None | $346.74 | $616.60 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $467.74 Median $1,258.93 Typical High $3,019.95 | Professional | None | $467.74 | $1,258.93 | $3,019.95 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,621.81 | Professional | None | $501.19 | $660.69 | $1,621.81 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $478.63 Typical High $707.95 | Facility | None | $346.74 | $478.63 | $707.95 |
Well Sense Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
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 $177.83 Median $177.83 Typical High $616.60 | Professional | 52 · Reduced service | $177.83 | $177.83 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $245.47 | Professional | 53 · Discontinued | $70.79 | $70.79 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $933.25 | Professional | 54 · Surgery only | $263.03 | $263.03 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $186.21 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $123.03 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $870.96 |
Where Massachusetts sits
The same service costs 7.2 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· 20th of 51
$661
OK $2,042UT $282
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.