How much rates vary
Facilitymedian $1,479 · 10th to 90th $457 to $5,495Professionalmedian $741 · 10th to 90th $407 to $3,020
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 $1,513.56 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $1,479.11 | Professional | None | $302.00 | $302.00 | $1,479.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $501.19 Median $1,949.84 Typical High $5,623.41 | Facility | None | $501.19 | $1,949.84 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $446.68 Median $1,096.48 Typical High $3,019.95 | Professional | None | $446.68 | $1,096.48 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,137.96 Typical High $3,090.30 | Facility | None | $446.68 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,445.44 | Professional | None | $707.95 | $707.95 | $1,445.44 |
Fallon Health Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $3,311.31 | Facility | None | $457.09 | $588.84 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $691.83 | Professional | None | $489.78 | $562.34 | $691.83 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $512.86 Median $954.99 Typical High $1,995.26 | Professional | None | $512.86 | $954.99 | $1,995.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $501.19 Median $1,949.84 Typical High $5,623.41 | Facility | None | $501.19 | $1,949.84 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $446.68 Median $1,096.48 Typical High $3,019.95 | Professional | None | $446.68 | $1,096.48 | $3,019.95 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,549.93 | Facility | None | $851.14 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,995.26 | Professional | None | $562.34 | $776.25 | $1,995.26 |
Well Sense Setting Facility Modifier None Typical Low $363.08 Median $645.65 Typical High $1,148.15 | Facility | None | $363.08 | $645.65 | $1,148.15 |
Well Sense Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | None | $380.19 | $380.19 | $457.09 |
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 $151.36 Median $151.36 Typical High $741.31 | Professional | 52 · Reduced service | $151.36 | $151.36 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $302.00 | Professional | 53 · Discontinued | $60.26 | $60.26 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $1,122.02 | Professional | 54 · Surgery only | $229.09 | $229.09 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $223.87 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $147.91 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $1,047.13 |
Where Massachusetts sits
The same service costs 5.1 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 $7,172MT $1,402
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.