How much rates vary
Facilitymedian $2,042 · 10th to 90th $692 to $6,310Professionalmedian $1,072 · 10th to 90th $676 to $5,888
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 $1,905.46 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,905.46 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,905.46 | Professional | None | $616.60 | $616.60 | $1,905.46 |
AllWays Health Partners Setting Facility Modifier None Typical Low $630.96 Median $2,187.76 Typical High $5,754.40 | Facility | None | $630.96 | $2,187.76 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $724.44 Median $1,659.59 Typical High $5,888.44 | Professional | None | $724.44 | $1,659.59 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,677.35 Typical High $7,079.46 | Facility | None | $831.76 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,862.09 | Professional | None | $933.25 | $933.25 | $1,862.09 |
Fallon Health Setting Facility Modifier None Typical Low $724.44 Median $933.25 Typical High $3,311.31 | Facility | None | $724.44 | $933.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,096.48 | Professional | None | $831.76 | $954.99 | $1,096.48 |
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 $794.33 Median $1,445.44 Typical High $2,187.76 | Professional | None | $794.33 | $1,445.44 | $2,187.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $630.96 Median $2,187.76 Typical High $5,754.40 | Facility | None | $630.96 | $2,187.76 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $724.44 Median $1,659.59 Typical High $5,888.44 | Professional | None | $724.44 | $1,659.59 | $5,888.44 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $12,302.69 | Facility | None | $851.14 | $2,818.38 | $12,302.69 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $2,951.21 | Professional | None | $758.58 | $1,071.52 | $2,951.21 |
Well Sense Setting Facility Modifier None Typical Low $549.54 Median $812.83 Typical High $2,398.83 | Facility | None | $549.54 | $812.83 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | None | $489.78 | $489.78 | $660.69 |
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 $309.03 Median $309.03 Typical High $954.99 | Professional | 52 · Reduced service | $309.03 | $309.03 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $389.05 | Professional | 53 · Discontinued | $123.03 | $123.03 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $1,445.44 | Professional | 54 · Surgery only | $457.09 | $457.09 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $288.40 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $190.55 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $1,348.96 |
Where Massachusetts sits
The same service costs 4.8 times more in Alaska 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
AK $10,454MT $2,169
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.