How much rates vary
Facilitymedian $245 · 10th to 90th $126 to $2,399Professionalmedian $316 · 10th to 90th $148 to $794
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 $691.83 Median $2,691.53 Typical High $3,715.35 | Facility | None | $691.83 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $562.34 | Professional | None | $95.50 | $162.18 | $562.34 |
AllWays Health Partners Setting Facility Modifier None Typical Low $125.89 Median $371.54 Typical High $2,041.74 | Facility | None | $125.89 | $371.54 | $2,041.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $162.18 Median $316.23 Typical High $1,949.84 | Professional | None | $162.18 | $316.23 | $1,949.84 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $131.83 Median $158.49 Typical High $302.00 | Facility | None | $131.83 | $158.49 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $478.63 Typical High $776.25 | Facility | None | $338.84 | $478.63 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $537.03 | Professional | None | $147.91 | $269.15 | $537.03 |
Fallon Health Setting Facility Modifier None Typical Low $131.83 Median $173.78 Typical High $3,311.31 | Facility | None | $131.83 | $173.78 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $467.74 | Professional | None | $338.84 | $398.11 | $467.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $169.82 Median $323.59 Typical High $741.31 | Professional | None | $169.82 | $323.59 | $741.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $125.89 Median $371.54 Typical High $2,041.74 | Facility | None | $125.89 | $371.54 | $2,041.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $162.18 Median $316.23 Typical High $1,949.84 | Professional | None | $162.18 | $316.23 | $1,949.84 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,754.23 | Facility | None | $123.03 | $549.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $165.96 Median $295.12 Typical High $602.56 | Professional | None | $165.96 | $295.12 | $602.56 |
Well Sense Setting Facility Modifier None Typical Low $102.33 Median $165.96 Typical High $263.03 | Facility | None | $102.33 | $165.96 | $263.03 |
Well Sense Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $263.03 | Professional | None | $158.49 | $186.21 | $263.03 |
5 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 $47.86 Median $79.43 Typical High $281.84 | Professional | 52 · Reduced service | $47.86 | $79.43 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $32.36 Typical High $112.20 | Professional | 53 · Discontinued | $19.05 | $32.36 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $120.23 Typical High $416.87 | Professional | 54 · Surgery only | $72.44 | $120.23 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $23.99 Typical High $83.18 | Professional | 55 · Aftercare only | $14.45 | $23.99 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $16.22 Typical High $56.23 | Professional | 56 · Pre-op care only | $9.55 | $16.22 | $56.23 |
Where Massachusetts sits
The same service costs 7.2 times more in New York than in Michigan. 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
NY $2,740MI $382
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.