How much rates vary
Facilitymedian $1,230 · 10th to 90th $575 to $4,677Professionalmedian $1,096 · 10th to 90th $708 to $11,482
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 $2,884.03 Typical High $4,677.35 | Facility | None | $1,949.84 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,949.84 | Professional | None | $676.08 | $676.08 | $1,949.84 |
AllWays Health Partners Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $5,011.87 | Facility | None | $501.19 | $1,778.28 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $794.33 Median $1,445.44 Typical High $11,481.54 | Professional | None | $794.33 | $1,445.44 | $11,481.54 |
BCBS Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,288.25 | Professional | None | $741.31 | $741.31 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,659.59 Typical High $2,398.83 | Facility | None | $676.08 | $1,659.59 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,862.09 | Professional | None | $933.25 | $933.25 | $1,862.09 |
Fallon Health Setting Facility Modifier None Typical Low $707.95 Median $933.25 Typical High $3,311.31 | Facility | None | $707.95 | $933.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,096.48 | Professional | None | $812.83 | $954.99 | $1,096.48 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $5,128.61 | Facility | None | $549.54 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $794.33 Median $1,412.54 Typical High $2,187.76 | Professional | None | $794.33 | $1,412.54 | $2,187.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $5,011.87 | Facility | None | $501.19 | $1,778.28 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $794.33 Median $1,445.44 Typical High $11,481.54 | Professional | None | $794.33 | $1,445.44 | $11,481.54 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $8,709.64 | Facility | None | $575.44 | $1,380.38 | $8,709.64 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $2,951.21 | Professional | None | $794.33 | $1,071.52 | $2,951.21 |
Well Sense Setting Facility Modifier None Typical Low $575.44 Median $794.33 Typical High $1,096.48 | Facility | None | $575.44 | $794.33 | $1,096.48 |
Well Sense Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $707.95 | Professional | None | $524.81 | $537.03 | $707.95 |
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 $338.84 Median $338.84 Typical High $1,202.26 | Professional | 52 · Reduced service | $338.84 | $338.84 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $489.78 | Professional | 53 · Discontinued | $134.90 | $134.90 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $1,819.70 | Professional | 54 · Surgery only | $501.19 | $501.19 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $363.08 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $245.47 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $1,698.24 |
Where Massachusetts sits
The same service costs 5.4 times more in Alabama 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
AL $8,418DE $1,559
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.