How much rates vary
Facilitymedian $1,288 · 10th to 90th $407 to $3,548Professionalmedian $1,778 · 10th to 90th $1,000 to $7,762
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 $724.44 Median $724.44 Typical High $1,819.70 | Professional | None | $724.44 | $724.44 | $1,819.70 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $870.96 Typical High $3,548.13 | Facility | None | $346.74 | $870.96 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,096.48 Median $2,818.38 Typical High $7,762.47 | Professional | None | $1,096.48 | $2,818.38 | $7,762.47 |
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 $1,778.28 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,778.28 | $1,778.28 | $3,467.37 |
Fallon Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $3,311.31 | Facility | None | $1,174.90 | $1,479.11 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,445.44 | $1,778.28 |
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 $1,288.25 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,288.25 | $2,344.23 | $3,548.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $870.96 Typical High $3,548.13 | Facility | None | $346.74 | $870.96 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,096.48 Median $2,818.38 Typical High $7,762.47 | Professional | None | $1,096.48 | $2,818.38 | $7,762.47 |
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 $1,230.27 Median $1,698.24 Typical High $4,786.30 | Professional | None | $1,230.27 | $1,698.24 | $4,786.30 |
Well Sense Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,659.59 | Facility | None | $794.33 | $1,122.02 | $1,659.59 |
Well Sense Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | None | $812.83 | $812.83 | $977.24 |
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 $363.08 Median $363.08 Typical High $1,584.89 | Professional | 52 · Reduced service | $363.08 | $363.08 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $630.96 | Professional | 53 · Discontinued | $144.54 | $144.54 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $2,344.23 | Professional | 54 · Surgery only | $549.54 | $549.54 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $478.63 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $316.23 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $2,187.76 |
Where Massachusetts sits
The same service costs 9.9 times more in Alabama than in Maryland. 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 $18,241MD $1,851
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.