How much rates vary
Facilitymedian $589 · 10th to 90th $129 to $2,239Professionalmedian $871 · 10th to 90th $468 to $2,239
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 $436.52 Median $467.74 Typical High $1,258.93 | Professional | None | $436.52 | $467.74 | $1,258.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $93.33 Median $467.74 Typical High $1,862.09 | Facility | None | $93.33 | $467.74 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $501.19 Median $1,047.13 Typical High $4,570.88 | Professional | None | $501.19 | $1,047.13 | $4,570.88 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $602.56 Median $724.44 Typical High $1,380.38 | Facility | None | $602.56 | $724.44 | $1,380.38 |
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 $645.65 Median $707.95 Typical High $1,288.25 | Professional | None | $645.65 | $707.95 | $1,288.25 |
Fallon Health Setting Facility Modifier None Typical Low $549.54 Median $758.58 Typical High $3,311.31 | Facility | None | $549.54 | $758.58 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,071.52 | Professional | None | $794.33 | $912.01 | $1,071.52 |
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 $616.60 Median $1,174.90 Typical High $1,737.80 | Professional | None | $616.60 | $1,174.90 | $1,737.80 |
Mass General Brigham Setting Facility Modifier None Typical Low $93.33 Median $467.74 Typical High $1,862.09 | Facility | None | $93.33 | $467.74 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $501.19 Median $1,047.13 Typical High $4,570.88 | Professional | None | $501.19 | $1,047.13 | $4,570.88 |
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 $549.54 Median $758.58 Typical High $2,238.72 | Professional | None | $549.54 | $758.58 | $2,238.72 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $478.63 Typical High $831.76 | Facility | None | $93.33 | $478.63 | $831.76 |
Well Sense Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $436.52 | Professional | None | $323.59 | $346.74 | $436.52 |
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 $218.78 Median $234.42 Typical High $630.96 | Professional | 52 · Reduced service | $218.78 | $234.42 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $93.33 Typical High $251.19 | Professional | 53 · Discontinued | $87.10 | $93.33 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $354.81 Typical High $933.25 | Professional | 54 · Surgery only | $323.59 | $354.81 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $70.79 Typical High $186.21 | Professional | 55 · Aftercare only | $64.57 | $70.79 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $125.89 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $331.13 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $302.00 | $331.13 | $870.96 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $630.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $407.38 | $630.96 | $2,137.96 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $223.87 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $204.17 | $223.87 | $309.03 |
Where Massachusetts sits
The same service costs 5.2 times more in Connecticut than in Delaware. 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 $3,468DE $666
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.