How much rates vary
Facilitymedian $537 · 10th to 90th $129 to $2,239Professionalmedian $794 · 10th to 90th $457 to $2,042
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 $1,000.00 Median $2,187.76 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $1,202.26 | Professional | None | $416.87 | $446.68 | $1,202.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $93.33 Median $380.19 Typical High $1,862.09 | Facility | None | $93.33 | $380.19 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $478.63 Median $933.25 Typical High $3,981.07 | Professional | None | $478.63 | $933.25 | $3,981.07 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $524.81 Median $630.96 Typical High $1,202.26 | Facility | None | $524.81 | $630.96 | $1,202.26 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,174.90 | Professional | None | $524.81 | $630.96 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $295.12 Typical High $489.78 | Facility | None | $204.17 | $295.12 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $1,230.27 | Professional | None | $630.96 | $676.08 | $1,230.27 |
Fallon Health Setting Facility Modifier None Typical Low $512.86 Median $645.65 Typical High $3,311.31 | Facility | None | $512.86 | $645.65 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $933.25 | Professional | None | $691.83 | $812.83 | $933.25 |
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 $549.54 Median $1,023.29 Typical High $1,548.82 | Professional | None | $549.54 | $1,023.29 | $1,548.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $93.33 Median $380.19 Typical High $1,862.09 | Facility | None | $93.33 | $380.19 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $478.63 Median $933.25 Typical High $3,981.07 | Professional | None | $478.63 | $933.25 | $3,981.07 |
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 $512.86 Median $724.44 Typical High $2,041.74 | Professional | None | $512.86 | $724.44 | $2,041.74 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $457.09 Typical High $794.33 | Facility | None | $93.33 | $457.09 | $794.33 |
Well Sense Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $416.87 | Professional | None | $309.03 | $331.13 | $416.87 |
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 $208.93 Median $223.87 Typical High $602.56 | Professional | 52 · Reduced service | $208.93 | $223.87 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $239.88 | Professional | 53 · Discontinued | $83.18 | $89.13 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $331.13 Typical High $912.01 | Professional | 54 · Surgery only | $309.03 | $331.13 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $181.97 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $120.23 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $309.03 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $288.40 | $309.03 | $851.14 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $208.93 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $194.98 | $208.93 | $295.12 |
Where Massachusetts sits
The same service costs 4.9 times more in Connecticut 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
CT $3,107FL $640
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.