How much rates vary
Facilitymedian $1,862 · 10th to 90th $631 to $7,244Professionalmedian $977 · 10th to 90th $537 to $5,012
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 $1,621.81 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,621.81 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $1,621.81 | Professional | None | $416.87 | $416.87 | $1,621.81 |
AllWays Health Partners Setting Facility Modifier None Typical Low $707.95 Median $3,467.37 Typical High $9,772.37 | Facility | None | $707.95 | $3,467.37 | $9,772.37 |
AllWays Health Partners Setting Professional Modifier None Typical Low $630.96 Median $1,621.81 Typical High $5,011.87 | Professional | None | $630.96 | $1,621.81 | $5,011.87 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,890.45 Typical High $5,754.40 | Facility | None | $831.76 | $3,890.45 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,819.70 | Professional | None | $977.24 | $977.24 | $1,819.70 |
Fallon Health Setting Facility Modifier None Typical Low $588.84 Median $758.58 Typical High $3,311.31 | Facility | None | $588.84 | $758.58 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $912.01 | Professional | None | $630.96 | $741.31 | $912.01 |
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 $630.96 Median $1,148.15 Typical High $2,089.30 | Professional | None | $630.96 | $1,148.15 | $2,089.30 |
Mass General Brigham Setting Facility Modifier None Typical Low $707.95 Median $3,467.37 Typical High $9,772.37 | Facility | None | $707.95 | $3,467.37 | $9,772.37 |
Mass General Brigham Setting Professional Modifier None Typical Low $630.96 Median $1,621.81 Typical High $5,011.87 | Professional | None | $630.96 | $1,621.81 | $5,011.87 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $15,488.17 | Facility | None | $1,071.52 | $3,890.45 | $15,488.17 |
United Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $2,089.30 | Professional | None | $660.69 | $851.14 | $2,089.30 |
Well Sense Setting Facility Modifier None Typical Low $501.19 Median $891.25 Typical High $1,862.09 | Facility | None | $501.19 | $891.25 | $1,862.09 |
Well Sense Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | None | $426.58 | $426.58 | $512.86 |
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 $208.93 Median $208.93 Typical High $812.83 | Professional | 52 · Reduced service | $208.93 | $208.93 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $331.13 | Professional | 53 · Discontinued | $83.18 | $83.18 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $1,230.27 | Professional | 54 · Surgery only | $316.23 | $316.23 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $245.47 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $162.18 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $1,148.15 |
Where Massachusetts sits
The same service costs 8.1 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· 16th of 51
$1,096
OK $3,467UT $427
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.