How much rates vary
Facilitymedian $1,862 · 10th to 90th $741 to $5,623Professionalmedian $1,288 · 10th to 90th $776 to $5,623
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 $741.31 Median $741.31 Typical High $2,238.72 | Professional | None | $741.31 | $741.31 | $2,238.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $5,754.40 | Facility | None | $645.65 | $2,089.30 | $5,754.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $851.14 Median $1,949.84 Typical High $5,623.41 | Professional | None | $851.14 | $1,949.84 | $5,623.41 |
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 $1,071.52 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 $1,071.52 Typical High $3,311.31 | Facility | None | $831.76 | $1,071.52 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,288.25 | Professional | None | $954.99 | $1,096.48 | $1,288.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $758.58 Median $2,818.38 Typical High $7,762.47 | Facility | None | $758.58 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $912.01 Median $1,698.24 Typical High $2,570.40 | Professional | None | $912.01 | $1,698.24 | $2,570.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $5,754.40 | Facility | None | $645.65 | $2,089.30 | $5,754.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $851.14 Median $1,949.84 Typical High $5,623.41 | Professional | None | $851.14 | $1,949.84 | $5,623.41 |
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 $870.96 Median $1,230.27 Typical High $3,715.35 | Professional | None | $870.96 | $1,230.27 | $3,715.35 |
Well Sense Setting Facility Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,380.38 | Facility | None | $676.08 | $1,071.52 | $1,380.38 |
Well Sense Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $776.25 | Professional | None | $575.44 | $575.44 | $776.25 |
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 $371.54 Median $371.54 Typical High $1,122.02 | Professional | 52 · Reduced service | $371.54 | $371.54 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $446.68 | Professional | 53 · Discontinued | $147.91 | $147.91 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $1,659.59 | Professional | 54 · Surgery only | $562.34 | $562.34 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $338.84 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $223.87 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $1,548.82 |
BCBS Massachusetts Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $177.83 Typical High $269.15 | Professional | AS · PA/NP assist | $131.83 | $177.83 | $269.15 |
Where Massachusetts sits
The same service costs 3.1 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 $8,115MD $2,591
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.