How much rates vary
Facilitymedian $2,089 · 10th to 90th $631 to $7,413Professionalmedian $933 · 10th to 90th $562 to $7,413
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 $1,819.70 Median $2,818.38 Typical High $5,128.61 | Facility | None | $1,819.70 | $2,818.38 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $1,000.00 | Professional | None | $398.11 | $398.11 | $1,000.00 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1,071.52 Median $3,235.94 Typical High $9,120.11 | Facility | None | $1,071.52 | $3,235.94 | $9,120.11 |
AllWays Health Partners Setting Professional Modifier None Typical Low $562.34 Median $1,412.54 Typical High $7,413.10 | Professional | None | $562.34 | $1,412.54 | $7,413.10 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $588.84 Median $954.99 Typical High $1,348.96 | Professional | None | $588.84 | $954.99 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $4,073.80 Typical High $6,025.60 | Facility | None | $446.68 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,584.89 | Professional | None | $891.25 | $891.25 | $1,584.89 |
Fallon Health Setting Facility Modifier None Typical Low $588.84 Median $758.58 Typical High $3,311.31 | Facility | None | $588.84 | $758.58 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $891.25 | Professional | None | $630.96 | $724.44 | $891.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $660.69 Median $1,230.27 Typical High $2,630.27 | Professional | None | $660.69 | $1,230.27 | $2,630.27 |
Mass General Brigham Setting Facility Modifier None Typical Low $1,071.52 Median $3,235.94 Typical High $9,120.11 | Facility | None | $1,071.52 | $3,235.94 | $9,120.11 |
Mass General Brigham Setting Professional Modifier None Typical Low $562.34 Median $1,412.54 Typical High $7,413.10 | Professional | None | $562.34 | $1,412.54 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $14,791.08 | Facility | None | $1,071.52 | $3,890.45 | $14,791.08 |
United Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $2,630.27 | Professional | None | $691.83 | $977.24 | $2,630.27 |
Well Sense Setting Facility Modifier None Typical Low $426.58 Median $575.44 Typical High $870.96 | Facility | None | $426.58 | $575.44 | $870.96 |
Well Sense Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $562.34 | Professional | None | $467.74 | $467.74 | $562.34 |
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 $199.53 Median $199.53 Typical High $912.01 | Professional | 52 · Reduced service | $199.53 | $199.53 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $363.08 | Professional | 53 · Discontinued | $79.43 | $79.43 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $1,348.96 | Professional | 54 · Surgery only | $295.12 | $295.12 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $269.15 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $181.97 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $1,258.93 |
Where Massachusetts sits
The same service costs 5.6 times more in Wisconsin 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
WI $10,313MT $1,845
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.