How much rates vary
Facilitymedian $257 · 10th to 90th $115 to $2,239Professionalmedian $417 · 10th to 90th $145 to $3,020
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 $537.03 Median $2,187.76 Typical High $3,630.78 | Facility | None | $537.03 | $2,187.76 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $223.87 Typical High $380.19 | Professional | None | $97.72 | $223.87 | $380.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $87.10 Median $323.59 Typical High $1,862.09 | Facility | None | $87.10 | $323.59 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $165.96 Median $489.78 Typical High $3,019.95 | Professional | None | $165.96 | $489.78 | $3,019.95 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $131.83 Median $158.49 Typical High $295.12 | Facility | None | $131.83 | $158.49 | $295.12 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $831.76 | Professional | None | $223.87 | $223.87 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $281.84 Typical High $489.78 | Facility | None | $194.98 | $281.84 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $501.19 Typical High $954.99 | Professional | None | $162.18 | $501.19 | $954.99 |
Fallon Health Setting Facility Modifier None Typical Low $131.83 Median $173.78 Typical High $3,311.31 | Facility | None | $131.83 | $173.78 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $724.44 | Professional | None | $501.19 | $616.60 | $724.44 |
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 $151.36 Median $416.87 Typical High $1,148.15 | Professional | None | $151.36 | $416.87 | $1,148.15 |
Mass General Brigham Setting Facility Modifier None Typical Low $87.10 Median $323.59 Typical High $1,862.09 | Facility | None | $87.10 | $323.59 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $165.96 Median $489.78 Typical High $3,019.95 | Professional | None | $165.96 | $489.78 | $3,019.95 |
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 $380.19 Typical High $1,148.15 | Professional | None | $173.78 | $380.19 | $1,148.15 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $158.49 Typical High $446.68 | Facility | None | $87.10 | $158.49 | $446.68 |
Well Sense Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $239.88 | Professional | None | $97.72 | $117.49 | $239.88 |
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 $48.98 Median $112.20 Typical High $190.55 | Professional | 52 · Reduced service | $48.98 | $112.20 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $44.67 Typical High $75.86 | Professional | 53 · Discontinued | $19.95 | $44.67 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $169.82 Typical High $288.40 | Professional | 54 · Surgery only | $74.13 | $169.82 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $33.88 Typical High $57.54 | Professional | 55 · Aftercare only | $14.79 | $33.88 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $22.39 Typical High $38.02 | Professional | 56 · Pre-op care only | $9.77 | $22.39 | $38.02 |
Where Massachusetts sits
The same service costs 6.9 times more in New York than in Alabama. 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 $2,939AL $425
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.