How much rates vary
Facilitymedian $2,089 · 10th to 90th $447 to $9,333Professionalmedian $7,413 · 10th to 90th $513 to $19,498
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 $3,467.37 Typical High $6,025.60 | Facility | None | $2,691.53 | $3,467.37 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $8,128.31 | Professional | None | $467.74 | $707.95 | $8,128.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $870.96 Median $3,467.37 Typical High $9,772.37 | Facility | None | $870.96 | $3,467.37 | $9,772.37 |
AllWays Health Partners Setting Professional Modifier None Typical Low $524.81 Median $8,128.31 Typical High $43,651.58 | Professional | None | $524.81 | $8,128.31 | $43,651.58 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $1,023.29 | Facility | None | $446.68 | $446.68 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $11,481.54 Typical High $14,791.08 | Facility | None | $676.08 | $11,481.54 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,584.89 Typical High $14,125.38 | Professional | None | $707.95 | $1,584.89 | $14,125.38 |
Fallon Health Setting Facility Modifier None Typical Low $446.68 Median $562.34 Typical High $3,311.31 | Facility | None | $446.68 | $562.34 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $7,943.28 Median $9,332.54 Typical High $12,589.25 | Professional | None | $7,943.28 | $9,332.54 | $12,589.25 |
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 $512.86 Median $5,623.41 Typical High $16,595.87 | Professional | None | $512.86 | $5,623.41 | $16,595.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $870.96 Median $3,467.37 Typical High $9,772.37 | Facility | None | $870.96 | $3,467.37 | $9,772.37 |
Mass General Brigham Setting Professional Modifier None Typical Low $524.81 Median $8,128.31 Typical High $43,651.58 | Professional | None | $524.81 | $8,128.31 | $43,651.58 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,982.44 | Facility | None | $1,071.52 | $3,890.45 | $16,982.44 |
United Setting Professional Modifier None Typical Low $512.86 Median $4,265.80 Typical High $16,982.44 | Professional | None | $512.86 | $4,265.80 | $16,982.44 |
Well Sense Setting Facility Modifier None Typical Low $389.05 Median $2,630.27 Typical High $7,244.36 | Facility | None | $389.05 | $2,630.27 | $7,244.36 |
Well Sense Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $6,760.83 | Professional | None | $338.84 | $501.19 | $6,760.83 |
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 $234.42 Median $2,511.89 Typical High $4,073.80 | Professional | 52 · Reduced service | $234.42 | $2,511.89 | $4,073.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $1,023.29 Typical High $1,621.81 | Professional | 53 · Discontinued | $93.33 | $1,023.29 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $3,801.89 Typical High $6,165.95 | Professional | 54 · Surgery only | $354.81 | $3,801.89 | $6,165.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $758.58 Typical High $1,230.27 | Professional | 55 · Aftercare only | $70.79 | $758.58 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $512.86 Typical High $812.83 | Professional | 56 · Pre-op care only | $46.77 | $512.86 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $3,548.13 Typical High $5,754.40 | Professional | 78 · Unplanned return to OR | $331.13 | $3,548.13 | $5,754.40 |
Where Massachusetts sits
The same service costs 4.1 times more in Iowa than in Delaware. 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
IA $18,453DE $4,539
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.