How much rates vary
Facilitymedian $1,862 · 10th to 90th $741 to $5,623Professionalmedian $1,445 · 10th to 90th $912 to $6,918
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 $1,949.84 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,454.71 | Professional | None | $812.83 | $812.83 | $2,454.71 |
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 $1,000.00 Median $2,187.76 Typical High $6,918.31 | Professional | None | $1,000.00 | $2,187.76 | $6,918.31 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $2,089.30 | Professional | None | $977.24 | $977.24 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,187.76 Typical High $3,162.28 | Facility | None | $831.76 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,202.26 | $2,398.83 |
Fallon Health Setting Facility Modifier None Typical Low $933.25 Median $1,202.26 Typical High $3,311.31 | Facility | None | $933.25 | $1,202.26 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,258.93 | $1,445.44 |
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 $1,023.29 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,023.29 | $1,905.46 | $2,884.03 |
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 $1,000.00 Median $2,187.76 Typical High $6,918.31 | Professional | None | $1,000.00 | $2,187.76 | $6,918.31 |
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 $1,023.29 Median $1,445.44 Typical High $3,981.07 | Professional | None | $1,023.29 | $1,445.44 | $3,981.07 |
Well Sense Setting Facility Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,412.54 | Facility | None | $741.31 | $1,023.29 | $1,412.54 |
Well Sense Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $831.76 | Professional | None | $616.60 | $616.60 | $831.76 |
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 $407.38 Median $407.38 Typical High $1,230.27 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $501.19 | Professional | 53 · Discontinued | $162.18 | $162.18 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $1,862.09 | Professional | 54 · Surgery only | $602.56 | $602.56 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $371.54 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $245.47 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,737.80 |
Where Massachusetts sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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 $7,993MD $2,690
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.