How much rates vary
Facilitymedian $1,380 · 10th to 90th $676 to $4,571Professionalmedian $1,318 · 10th to 90th $794 to $5,129
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 $2,089.30 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,089.30 | $3,019.95 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $870.96 | Professional | None | $794.33 | $794.33 | $870.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $4,265.80 | Facility | None | $602.56 | $1,698.24 | $4,265.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $794.33 Median $1,862.09 Typical High $5,128.61 | Professional | None | $794.33 | $1,862.09 | $5,128.61 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $1,698.24 | Professional | None | $794.33 | $1,202.26 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,949.84 Typical High $2,511.89 | Facility | None | $676.08 | $1,949.84 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $2,818.38 | Professional | None | $891.25 | $1,202.26 | $2,818.38 |
Fallon Health Setting Facility Modifier None Typical Low $758.58 Median $1,000.00 Typical High $3,311.31 | Facility | None | $758.58 | $1,000.00 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,380.38 | Professional | None | $851.14 | $1,023.29 | $1,380.38 |
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 $831.76 Median $1,621.81 Typical High $2,398.83 | Professional | None | $831.76 | $1,621.81 | $2,398.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $4,265.80 | Facility | None | $602.56 | $1,698.24 | $4,265.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $794.33 Median $1,862.09 Typical High $5,128.61 | Professional | None | $794.33 | $1,862.09 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,344.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $2,951.21 | Professional | None | $812.83 | $1,174.90 | $2,951.21 |
Well Sense Setting Facility Modifier None Typical Low $562.34 Median $851.14 Typical High $1,230.27 | Facility | None | $562.34 | $851.14 | $1,230.27 |
Well Sense Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | None | $562.34 | $562.34 | $676.08 |
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 $398.11 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $549.54 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,096.48 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $630.96 | $1,096.48 | $1,445.44 |
Where Massachusetts sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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.
Physician feeFacility fee
OK $7,181MS $1,948
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.