How much rates vary
Facilitymedian $1,318 · 10th to 90th $380 to $5,248Professionalmedian $575 · 10th to 90th $316 to $3,981
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 $3,090.30 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $758.58 | Professional | None | $275.42 | $275.42 | $758.58 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $5,623.41 | Facility | None | $602.56 | $1,995.26 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $371.54 Median $912.01 Typical High $3,981.07 | Professional | None | $371.54 | $912.01 | $3,981.07 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,630.27 Typical High $3,311.31 | Facility | None | $831.76 | $2,630.27 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $1,096.48 | Professional | None | $446.68 | $467.74 | $1,096.48 |
Fallon Health Setting Facility Modifier None Typical Low $338.84 Median $426.58 Typical High $3,311.31 | Facility | None | $338.84 | $426.58 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $524.81 | Professional | None | $354.81 | $426.58 | $524.81 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $371.54 Median $676.08 Typical High $1,479.11 | Professional | None | $371.54 | $676.08 | $1,479.11 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $5,623.41 | Facility | None | $602.56 | $1,995.26 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $371.54 Median $912.01 Typical High $3,981.07 | Professional | None | $371.54 | $912.01 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,047.13 | $2,344.23 | $9,772.37 |
United Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $1,479.11 | Professional | None | $398.11 | $549.54 | $1,479.11 |
Well Sense Setting Facility Modifier None Typical Low $269.15 Median $457.09 Typical High $1,047.13 | Facility | None | $269.15 | $457.09 | $1,047.13 |
Well Sense Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | None | $269.15 | $269.15 | $323.59 |
3 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 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $776.25 | Professional | 54 · Surgery only | $208.93 | $208.93 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $154.88 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $104.71 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $104.71 |
Where Massachusetts sits
The same service costs 6.7 times more in Oklahoma than in Montana. 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
OK $7,024MT $1,050
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.