How much rates vary
Facilitymedian $1,950 · 10th to 90th $794 to $8,318Professionalmedian $1,349 · 10th to 90th $794 to $6,166
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 $2,511.89 Median $2,818.38 Typical High $5,128.61 | Facility | None | $2,511.89 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $2,511.89 | Professional | None | $794.33 | $794.33 | $2,511.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $831.76 Median $3,890.45 Typical High $14,454.40 | Facility | None | $831.76 | $3,890.45 | $14,454.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $912.01 Median $1,949.84 Typical High $6,165.95 | Professional | None | $912.01 | $1,949.84 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,187.76 Typical High $3,162.28 | Facility | None | $741.31 | $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 $776.25 Median $1,047.13 Typical High $3,311.31 | Facility | None | $776.25 | $1,047.13 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,230.27 | Professional | None | $933.25 | $1,071.52 | $1,230.27 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $912.01 Median $1,698.24 Typical High $2,398.83 | Professional | None | $912.01 | $1,698.24 | $2,398.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $831.76 Median $3,890.45 Typical High $14,454.40 | Facility | None | $831.76 | $3,890.45 | $14,454.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $912.01 Median $1,949.84 Typical High $6,165.95 | Professional | None | $912.01 | $1,949.84 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $12,022.64 | Facility | None | $1,071.52 | $3,890.45 | $12,022.64 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $3,715.35 | Professional | None | $977.24 | $1,288.25 | $3,715.35 |
Well Sense Setting Facility Modifier None Typical Low $630.96 Median $870.96 Typical High $1,288.25 | Facility | None | $630.96 | $870.96 | $1,288.25 |
Well Sense Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
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 $398.11 Median $398.11 Typical High $1,258.93 | Professional | 52 · Reduced service | $398.11 | $398.11 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $501.19 | Professional | 53 · Discontinued | $158.49 | $158.49 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $1,905.46 | Professional | 54 · Surgery only | $588.84 | $588.84 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $380.19 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $251.19 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $1,778.28 |
Where Massachusetts sits
The same service costs 5.0 times more in Alabama than in Kentucky. 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
AL $11,256KY $2,261
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.