How much rates vary
Facilitymedian $257 · 10th to 90th $117 to $2,399Professionalmedian $661 · 10th to 90th $141 to $1,950
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $467.74 Typical High $794.33 | Professional | None | $85.11 | $467.74 | $794.33 |
AllWays Health Partners Setting Facility Modifier None Typical Low $102.33 Median $501.19 Typical High $2,344.23 | Facility | None | $102.33 | $501.19 | $2,344.23 |
AllWays Health Partners Setting Professional Modifier None Typical Low $144.54 Median $691.83 Typical High $4,265.80 | Professional | None | $144.54 | $691.83 | $4,265.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $323.59 | Facility | None | $138.04 | $138.04 | $323.59 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $138.04 Median $691.83 Typical High $1,230.27 | Professional | None | $138.04 | $691.83 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $758.58 Typical High $1,000.00 | Facility | None | $676.08 | $758.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $616.60 Typical High $1,548.82 | Professional | None | $223.87 | $616.60 | $1,548.82 |
Fallon Health Setting Facility Modifier None Typical Low $128.82 Median $177.83 Typical High $3,311.31 | Facility | None | $128.82 | $177.83 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,047.13 | Professional | None | $707.95 | $851.14 | $1,047.13 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $154.88 Median $630.96 Typical High $1,659.59 | Professional | None | $154.88 | $630.96 | $1,659.59 |
Mass General Brigham Setting Facility Modifier None Typical Low $102.33 Median $501.19 Typical High $2,344.23 | Facility | None | $102.33 | $501.19 | $2,344.23 |
Mass General Brigham Setting Professional Modifier None Typical Low $144.54 Median $691.83 Typical High $4,265.80 | Professional | None | $144.54 | $691.83 | $4,265.80 |
United Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $2,818.38 | Facility | None | $117.49 | $537.03 | $2,818.38 |
United Setting Professional Modifier None Typical Low $186.21 Median $645.65 Typical High $2,089.30 | Professional | None | $186.21 | $645.65 | $2,089.30 |
Well Sense Setting Facility Modifier None Typical Low $123.03 Median $239.88 Typical High $758.58 | Facility | None | $123.03 | $239.88 | $758.58 |
Well Sense Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $489.78 | Professional | None | $85.11 | $102.33 | $489.78 |
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 $41.69 Median $208.93 Typical High $269.15 | Professional | 52 · Reduced service | $41.69 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $83.18 Typical High $107.15 | Professional | 53 · Discontinued | $16.98 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $309.03 Typical High $398.11 | Professional | 54 · Surgery only | $63.10 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $61.66 Typical High $79.43 | Professional | 55 · Aftercare only | $12.59 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $41.69 Typical High $53.70 | Professional | 56 · Pre-op care only | $8.51 | $41.69 | $53.70 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $190.55 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $144.54 | $190.55 | $251.19 |
Where Massachusetts sits
The same service costs 17.4 times more in Alabama 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
AL $9,157MT $526
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.