How much rates vary
Facilitymedian $214 · 10th to 90th $98 to $1,820Professionalmedian $324 · 10th to 90th $158 to $832
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 $128.82 Median $213.80 Typical High $588.84 | Facility | None | $128.82 | $213.80 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $380.19 | Professional | None | $128.82 | $213.80 | $380.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $97.72 Median $371.54 Typical High $1,862.09 | Facility | None | $97.72 | $371.54 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $158.49 Median $354.81 Typical High $1,905.46 | Professional | None | $158.49 | $354.81 | $1,905.46 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $151.36 Median $181.97 Typical High $338.84 | Facility | None | $151.36 | $181.97 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $204.17 Typical High $295.12 | Facility | None | $53.70 | $204.17 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $537.03 | Professional | None | $186.21 | $323.59 | $537.03 |
Fallon Health Setting Facility Modifier None Typical Low $131.83 Median $186.21 Typical High $3,311.31 | Facility | None | $131.83 | $186.21 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $457.09 | Professional | None | $338.84 | $389.05 | $457.09 |
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 $165.96 Median $346.74 Typical High $724.44 | Professional | None | $165.96 | $346.74 | $724.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $97.72 Median $371.54 Typical High $1,862.09 | Facility | None | $97.72 | $371.54 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $158.49 Median $354.81 Typical High $1,905.46 | Professional | None | $158.49 | $354.81 | $1,905.46 |
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 $173.78 Median $295.12 Typical High $676.08 | Professional | None | $173.78 | $295.12 | $676.08 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $162.18 Typical High $263.03 | Facility | None | $97.72 | $162.18 | $263.03 |
Well Sense Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $177.83 | Professional | None | $95.50 | $128.82 | $177.83 |
5 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 $64.57 Median $107.15 Typical High $190.55 | Professional | 52 · Reduced service | $64.57 | $107.15 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $42.66 Typical High $75.86 | Professional | 53 · Discontinued | $25.70 | $42.66 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $32.36 Typical High $57.54 | Professional | 55 · Aftercare only | $19.50 | $32.36 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $21.38 Typical High $38.02 | Professional | 56 · Pre-op care only | $12.88 | $21.38 | $38.02 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $93.33 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $61.66 | $93.33 | $128.82 |
Where Massachusetts sits
The same service costs 8.0 times more in New York 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
NY $2,495MD $313
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.