How much rates vary
Facilitymedian $1,820 · 10th to 90th $407 to $3,715Professionalmedian $2,570 · 10th to 90th $1,549 to $11,220
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 $3,090.30 Typical High $5,128.61 | Facility | None | $2,691.53 | $3,090.30 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $4,897.79 | Professional | None | $1,122.02 | $1,122.02 | $4,897.79 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,073.80 | Facility | None | $346.74 | $1,047.13 | $4,073.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,621.81 Median $4,073.80 Typical High $11,220.18 | Professional | None | $1,621.81 | $4,073.80 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $1,380.38 | Facility | None | $50.12 | $954.99 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $4,570.88 | Professional | None | $2,570.40 | $2,570.40 | $4,570.88 |
Fallon Health Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $3,311.31 | Facility | None | $1,698.24 | $2,089.30 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,819.70 | $2,089.30 | $2,570.40 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,905.46 Median $3,467.37 Typical High $5,248.07 | Professional | None | $1,905.46 | $3,467.37 | $5,248.07 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $4,073.80 | Facility | None | $346.74 | $1,047.13 | $4,073.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,621.81 Median $4,073.80 Typical High $11,220.18 | Professional | None | $1,621.81 | $4,073.80 | $11,220.18 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,691.53 Typical High $7,585.78 | Professional | None | $1,949.84 | $2,691.53 | $7,585.78 |
Well Sense Setting Facility Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,570.40 | Facility | None | $1,258.93 | $1,698.24 | $2,570.40 |
Well Sense Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,258.93 | $1,513.56 |
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 $562.34 Median $562.34 Typical High $2,454.71 | Professional | 52 · Reduced service | $562.34 | $562.34 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $977.24 | Professional | 53 · Discontinued | $223.87 | $223.87 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $3,630.78 | Professional | 54 · Surgery only | $831.76 | $831.76 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $741.31 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $489.78 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $3,388.44 |
Where Massachusetts sits
The same service costs 7.9 times more in Alabama than in Washington. 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
AL $19,273WA $2,428
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.