How much rates vary
Facilitymedian $1,820 · 10th to 90th $692 to $5,623Professionalmedian $1,349 · 10th to 90th $794 to $5,754
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 $2,089.30 Median $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $2,137.96 | Professional | None | $691.83 | $691.83 | $2,137.96 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $5,754.40 | Facility | None | $549.54 | $2,137.96 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $891.25 Median $1,995.26 Typical High $5,754.40 | Professional | None | $891.25 | $1,995.26 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,187.76 Typical High $3,162.28 | Facility | None | $676.08 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,071.52 | $2,137.96 |
Fallon Health Setting Facility Modifier None Typical Low $831.76 Median $1,122.02 Typical High $3,311.31 | Facility | None | $831.76 | $1,122.02 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,174.90 | $1,380.38 |
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 $954.99 Median $1,737.80 Typical High $2,630.27 | Professional | None | $954.99 | $1,737.80 | $2,630.27 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $5,754.40 | Facility | None | $549.54 | $2,137.96 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $891.25 Median $1,995.26 Typical High $5,754.40 | Professional | None | $891.25 | $1,995.26 | $5,754.40 |
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 $891.25 Median $1,258.93 Typical High $3,548.13 | Professional | None | $891.25 | $1,258.93 | $3,548.13 |
Well Sense Setting Facility Modifier None Typical Low $645.65 Median $933.25 Typical High $1,380.38 | Facility | None | $645.65 | $933.25 | $1,380.38 |
Well Sense Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | None | $537.03 | $537.03 | $724.44 |
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 $346.74 Median $346.74 Typical High $1,071.52 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $426.58 | Professional | 53 · Discontinued | $138.04 | $138.04 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $524.81 | $524.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $323.59 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $213.80 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,513.56 |
Where Massachusetts sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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 $7,619HI $2,493
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.