How much rates vary
Facilitymedian $398 · 10th to 90th $135 to $3,311Professionalmedian $295 · 10th to 90th $145 to $1,549
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 $616.60 Median $2,691.53 Typical High $3,715.35 | Facility | None | $616.60 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $371.54 | Professional | None | $112.20 | $186.21 | $371.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $309.03 Median $1,071.52 Typical High $3,630.78 | Facility | None | $309.03 | $1,071.52 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $151.36 Median $363.08 Typical High $1,548.82 | Professional | None | $151.36 | $363.08 | $1,548.82 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $323.59 | Facility | None | $141.25 | $169.82 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $309.03 Typical High $831.76 | Facility | None | $100.00 | $309.03 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $616.60 | Professional | None | $169.82 | $275.42 | $616.60 |
Fallon Health Setting Facility Modifier None Typical Low $138.04 Median $181.97 Typical High $3,311.31 | Facility | None | $138.04 | $181.97 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $389.05 | Professional | None | $257.04 | $316.23 | $389.05 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $144.54 Median $316.23 Typical High $616.60 | Professional | None | $144.54 | $316.23 | $616.60 |
Mass General Brigham Setting Facility Modifier None Typical Low $309.03 Median $1,071.52 Typical High $3,630.78 | Facility | None | $309.03 | $1,071.52 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $151.36 Median $363.08 Typical High $1,548.82 | Professional | None | $151.36 | $363.08 | $1,548.82 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,165.95 | Facility | None | $575.44 | $1,380.38 | $6,165.95 |
United Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $645.65 | Professional | None | $147.91 | $288.40 | $645.65 |
Well Sense Setting Facility Modifier None Typical Low $123.03 Median $165.96 Typical High $257.04 | Facility | None | $123.03 | $165.96 | $257.04 |
Well Sense Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $186.21 | Professional | None | $95.50 | $112.20 | $186.21 |
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 $56.23 Median $93.33 Typical High $186.21 | Professional | 52 · Reduced service | $56.23 | $93.33 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $37.15 Typical High $74.13 | Professional | 53 · Discontinued | $22.39 | $37.15 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $141.25 Typical High $281.84 | Professional | 54 · Surgery only | $83.18 | $141.25 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $28.18 Typical High $56.23 | Professional | 55 · Aftercare only | $16.98 | $28.18 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $18.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $11.22 | $18.62 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $131.83 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $77.62 | $131.83 | $263.03 |
Where Massachusetts sits
The same service costs 3.9 times more in Oklahoma than in Kentucky. 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· 9th of 51
$302
OK $646KY $166
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.