How much rates vary
Facilitymedian $1,413 · 10th to 90th $513 to $5,888Professionalmedian $759 · 10th to 90th $437 to $3,090
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 $1,513.56 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,513.56 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $1,513.56 | Professional | None | $331.13 | $331.13 | $1,513.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $954.99 Median $2,137.96 Typical High $6,025.60 | Facility | None | $954.99 | $2,137.96 | $6,025.60 |
AllWays Health Partners Setting Professional Modifier None Typical Low $457.09 Median $1,148.15 Typical High $3,090.30 | Professional | None | $457.09 | $1,148.15 | $3,090.30 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,071.52 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,754.23 Typical High $4,073.80 | Facility | None | $446.68 | $2,754.23 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,318.26 | Professional | None | $741.31 | $741.31 | $1,318.26 |
Fallon Health Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $3,311.31 | Facility | None | $457.09 | $588.84 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $707.95 | Professional | None | $501.19 | $575.44 | $707.95 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $512.86 Median $977.24 Typical High $2,137.96 | Professional | None | $512.86 | $977.24 | $2,137.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $954.99 Median $2,137.96 Typical High $6,025.60 | Facility | None | $954.99 | $2,137.96 | $6,025.60 |
Mass General Brigham Setting Professional Modifier None Typical Low $457.09 Median $1,148.15 Typical High $3,090.30 | Professional | None | $457.09 | $1,148.15 | $3,090.30 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,772.37 | Facility | None | $851.14 | $2,818.38 | $9,772.37 |
United Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $2,137.96 | Professional | None | $588.84 | $794.33 | $2,137.96 |
Well Sense Setting Facility Modifier None Typical Low $389.05 Median $707.95 Typical High $1,288.25 | Facility | None | $389.05 | $707.95 | $1,288.25 |
Well Sense Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | None | $389.05 | $389.05 | $457.09 |
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 $165.96 Median $165.96 Typical High $758.58 | Professional | 52 · Reduced service | $165.96 | $165.96 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $302.00 | Professional | 53 · Discontinued | $66.07 | $66.07 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $1,148.15 | Professional | 54 · Surgery only | $245.47 | $245.47 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $229.09 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $151.36 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $1,071.52 |
Where Massachusetts sits
The same service costs 5.4 times more in Connecticut 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
CT $7,713MT $1,433
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.