How much rates vary
Facilitymedian $1,585 · 10th to 90th $550 to $5,623Professionalmedian $741 · 10th to 90th $457 to $3,981
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 $2,691.53 Median $3,388.44 Typical High $8,709.64 | Facility | None | $2,691.53 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $1,258.93 | Professional | None | $416.87 | $416.87 | $1,258.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $954.99 Median $2,041.74 Typical High $5,754.40 | Facility | None | $954.99 | $2,041.74 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $489.78 Median $1,122.02 Typical High $3,981.07 | Professional | None | $489.78 | $1,122.02 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,187.76 Typical High $3,162.28 | Facility | None | $1,318.26 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,230.27 | Professional | None | $616.60 | $616.60 | $1,230.27 |
Fallon Health Setting Facility Modifier None Typical Low $501.19 Median $645.65 Typical High $3,311.31 | Facility | None | $501.19 | $645.65 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $758.58 | Professional | None | $562.34 | $645.65 | $758.58 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $537.03 Median $977.24 Typical High $1,479.11 | Professional | None | $537.03 | $977.24 | $1,479.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $954.99 Median $2,041.74 Typical High $5,754.40 | Facility | None | $954.99 | $2,041.74 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $489.78 Median $1,122.02 Typical High $3,981.07 | Professional | None | $489.78 | $1,122.02 | $3,981.07 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $2,089.30 | Professional | None | $524.81 | $741.31 | $2,089.30 |
Well Sense Setting Facility Modifier None Typical Low $380.19 Median $691.83 Typical High $1,096.48 | Facility | None | $380.19 | $691.83 | $1,096.48 |
Well Sense Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $426.58 | Professional | None | $316.23 | $316.23 | $426.58 |
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 $630.96 | Professional | 52 · Reduced service | $208.93 | $208.93 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $251.19 | Professional | 53 · Discontinued | $83.18 | $83.18 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $954.99 | Professional | 54 · Surgery only | $309.03 | $309.03 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $190.55 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $125.89 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $891.25 |
Where Massachusetts sits
The same service costs 5.1 times more in Washington, DC 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
DC $7,757MT $1,518
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.