How much rates vary
Facilitymedian $1,585 · 10th to 90th $631 to $5,623Professionalmedian $891 · 10th to 90th $537 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 $2,570.40 Median $3,090.30 Typical High $6,309.57 | Facility | None | $2,570.40 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,621.81 | Professional | None | $524.81 | $524.81 | $1,621.81 |
AllWays Health Partners Setting Facility Modifier None Typical Low $691.83 Median $2,041.74 Typical High $5,754.40 | Facility | None | $691.83 | $2,041.74 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $575.44 Median $1,202.26 Typical High $3,981.07 | Professional | None | $575.44 | $1,202.26 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,187.76 Typical High $3,162.28 | Facility | None | $954.99 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,513.56 | Professional | None | $758.58 | $758.58 | $1,513.56 |
Fallon Health Setting Facility Modifier None Typical Low $588.84 Median $776.25 Typical High $3,311.31 | Facility | None | $588.84 | $776.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $891.25 | Professional | None | $660.69 | $758.58 | $891.25 |
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 $630.96 Median $1,174.90 Typical High $1,737.80 | Professional | None | $630.96 | $1,174.90 | $1,737.80 |
Health New England Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Mass General Brigham Setting Facility Modifier None Typical Low $691.83 Median $2,041.74 Typical High $5,754.40 | Facility | None | $691.83 | $2,041.74 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $575.44 Median $1,202.26 Typical High $3,981.07 | Professional | None | $575.44 | $1,202.26 | $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 $645.65 Median $912.01 Typical High $2,454.71 | Professional | None | $645.65 | $912.01 | $2,454.71 |
Well Sense Setting Facility Modifier None Typical Low $467.74 Median $741.31 Typical High $1,096.48 | Facility | None | $467.74 | $741.31 | $1,096.48 |
Well Sense Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $549.54 | Professional | None | $407.38 | $407.38 | $549.54 |
7 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 $257.04 Median $257.04 Typical High $794.33 | Professional | 52 · Reduced service | $257.04 | $257.04 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $323.59 | Professional | 53 · Discontinued | $104.71 | $104.71 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $1,202.26 | Professional | 54 · Surgery only | $389.05 | $389.05 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $239.88 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $162.18 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $1,122.02 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $812.83 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $478.63 | $812.83 | $1,096.48 |
Where Massachusetts sits
The same service costs 4.2 times more in Wisconsin 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
WI $7,546MT $1,803
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.