How much rates vary
Facilitymedian $398 · 10th to 90th $93 to $1,995Professionalmedian $537 · 10th to 90th $295 to $1,259
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 $295.12 Median $2,691.53 Typical High $5,128.61 | Facility | None | $295.12 | $2,691.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $724.44 | Professional | None | $251.19 | $295.12 | $724.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $93.33 Median $331.13 Typical High $1,819.70 | Facility | None | $93.33 | $331.13 | $1,819.70 |
AllWays Health Partners Setting Professional Modifier None Typical Low $302.00 Median $645.65 Typical High $2,818.38 | Professional | None | $302.00 | $645.65 | $2,818.38 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $794.33 | Facility | None | $346.74 | $416.87 | $794.33 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $794.33 | Professional | None | $346.74 | $446.68 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $181.97 Typical High $263.03 | Facility | None | $53.70 | $181.97 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $812.83 | Professional | None | $389.05 | $457.09 | $812.83 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $416.87 Typical High $3,311.31 | Facility | None | $177.83 | $416.87 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $660.69 | Professional | None | $501.19 | $575.44 | $660.69 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $363.08 Median $691.83 Typical High $1,071.52 | Professional | None | $363.08 | $691.83 | $1,071.52 |
Mass General Brigham Setting Facility Modifier None Typical Low $93.33 Median $331.13 Typical High $1,819.70 | Facility | None | $93.33 | $331.13 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None Typical Low $302.00 Median $645.65 Typical High $2,818.38 | Professional | None | $302.00 | $645.65 | $2,818.38 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $1,258.93 | Professional | None | $323.59 | $457.09 | $1,258.93 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $295.12 Typical High $501.19 | Facility | None | $93.33 | $295.12 | $501.19 |
Well Sense Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $263.03 | Professional | None | $190.55 | $218.78 | $263.03 |
8 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 $125.89 Median $147.91 Typical High $363.08 | Professional | 52 · Reduced service | $125.89 | $147.91 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $58.88 Typical High $144.54 | Professional | 53 · Discontinued | $51.29 | $58.88 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $223.87 Typical High $549.54 | Professional | 54 · Surgery only | $190.55 | $223.87 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $44.67 Typical High $109.65 | Professional | 55 · Aftercare only | $38.02 | $44.67 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $29.51 Typical High $72.44 | Professional | 56 · Pre-op care only | $25.12 | $29.51 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $208.93 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $177.83 | $208.93 | $512.86 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $354.81 Typical High $1,230.27 | Professional | 54 · Surgery only | $234.42 | $354.81 | $1,230.27 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $138.04 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $120.23 | $138.04 | $186.21 |
Where Massachusetts sits
The same service costs 6.7 times more in New York than in Florida. 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
NY $2,828FL $419
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.