How much rates vary
Facilitymedian $631 · 10th to 90th $219 to $3,388Professionalmedian $479 · 10th to 90th $240 to $1,096
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 $165.96 Median $245.47 Typical High $295.12 | Professional | None | $165.96 | $245.47 | $295.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $331.13 Median $1,174.90 Typical High $3,630.78 | Facility | None | $331.13 | $1,174.90 | $3,630.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $245.47 Median $512.86 Typical High $2,691.53 | Professional | None | $245.47 | $512.86 | $2,691.53 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $501.19 | Facility | None | $218.78 | $218.78 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $2,187.76 | Facility | None | $630.96 | $1,698.24 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $812.83 | Professional | None | $239.88 | $389.05 | $812.83 |
Fallon Health Setting Facility Modifier None Typical Low $218.78 Median $288.40 Typical High $3,311.31 | Facility | None | $218.78 | $288.40 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $630.96 | Professional | None | $457.09 | $537.03 | $630.96 |
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 $275.42 Median $512.86 Typical High $1,023.29 | Professional | None | $275.42 | $512.86 | $1,023.29 |
Mass General Brigham Setting Facility Modifier None Typical Low $331.13 Median $1,174.90 Typical High $3,630.78 | Facility | None | $331.13 | $1,174.90 | $3,630.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $245.47 Median $512.86 Typical High $2,691.53 | Professional | None | $245.47 | $512.86 | $2,691.53 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $6,918.31 | Facility | None | $575.44 | $1,380.38 | $6,918.31 |
United Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $933.25 | Professional | None | $251.19 | $457.09 | $933.25 |
Well Sense Setting Facility Modifier None Typical Low $194.98 Median $338.84 Typical High $691.83 | Facility | None | $194.98 | $338.84 | $691.83 |
Well Sense Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $281.84 | Professional | None | $165.96 | $199.53 | $281.84 |
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 $83.18 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $83.18 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $33.11 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $123.03 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $25.12 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.60 | $24.55 | $24.55 |
Where Massachusetts sits
The same service costs 6.1 times more in Michigan than in Montana. 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
MI $4,783MT $790
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.