How much rates vary
Facilitymedian $3,388 · 10th to 90th $339 to $31,623Professionalmedian $513 · 10th to 90th $295 to $2,089
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 $2,691.53 Median $4,265.80 Typical High $7,762.47 | Facility | None | $2,691.53 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $363.08 | Professional | None | $229.09 | $229.09 | $363.08 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,778.28 Median $10,471.29 Typical High $51,286.14 | Facility | None | $1,778.28 | $10,471.29 | $51,286.14 |
AllWays Health Partners Setting Professional Modifier None Typical Low $363.08 Median $776.25 Typical High $2,089.30 | Professional | None | $363.08 | $776.25 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $831.76 Typical High $11,220.18 | Facility | None | $676.08 | $831.76 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $891.25 | Professional | None | $501.19 | $501.19 | $891.25 |
Fallon Health Setting Facility Modifier None Typical Low $309.03 Median $398.11 Typical High $3,311.31 | Facility | None | $309.03 | $398.11 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $467.74 | Professional | None | $331.13 | $380.19 | $467.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,737.80 Median $4,677.35 Typical High $25,118.86 | Facility | None | $1,737.80 | $4,677.35 | $25,118.86 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $346.74 Median $645.65 Typical High $1,412.54 | Professional | None | $346.74 | $645.65 | $1,412.54 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,778.28 Median $10,471.29 Typical High $51,286.14 | Facility | None | $1,778.28 | $10,471.29 | $51,286.14 |
Mass General Brigham Setting Professional Modifier None Typical Low $363.08 Median $776.25 Typical High $2,089.30 | Professional | None | $363.08 | $776.25 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $5,754.40 Typical High $51,286.14 | Facility | None | $1,778.28 | $5,754.40 | $51,286.14 |
United Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $1,412.54 | Professional | None | $398.11 | $549.54 | $1,412.54 |
Well Sense Setting Facility Modifier None Typical Low $263.03 Median $407.38 Typical High $20,892.96 | Facility | None | $263.03 | $407.38 | $20,892.96 |
Well Sense Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | None | $257.04 | $257.04 | $309.03 |
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 $114.82 Median $114.82 Typical High $181.97 | Professional | 52 · Reduced service | $114.82 | $114.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $72.44 | Professional | 53 · Discontinued | $46.77 | $46.77 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $269.15 | Professional | 54 · Surgery only | $173.78 | $173.78 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $53.70 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Where Massachusetts sits
The same service costs 45.0 times more in New Mexico 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
NM $44,130MT $980
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.