How much rates vary
Facilitymedian $603 · 10th to 90th $117 to $3,548Professionalmedian $166 · 10th to 90th $102 to $692
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 $1,548.82 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,548.82 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $114.82 | Professional | None | $102.33 | $102.33 | $114.82 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $870.96 Typical High $3,311.31 | Facility | None | $323.59 | $870.96 | $3,311.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $107.15 Median $251.19 Typical High $691.83 | Professional | None | $107.15 | $251.19 | $691.83 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $269.15 | Professional | None | $104.71 | $169.82 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $831.76 Typical High $1,000.00 | Facility | None | $630.96 | $831.76 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $269.15 | Professional | None | $158.49 | $165.96 | $269.15 |
Fallon Health Setting Facility Modifier None Typical Low $104.71 Median $138.04 Typical High $3,311.31 | Facility | None | $104.71 | $138.04 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $181.97 | Professional | None | $114.82 | $134.90 | $181.97 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,128.61 | Facility | None | $501.19 | $1,318.26 | $5,128.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $114.82 Median $218.78 Typical High $323.59 | Professional | None | $114.82 | $218.78 | $323.59 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $870.96 Typical High $3,311.31 | Facility | None | $323.59 | $870.96 | $3,311.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $107.15 Median $251.19 Typical High $691.83 | Professional | None | $107.15 | $251.19 | $691.83 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,348.96 Typical High $5,128.61 | Facility | None | $575.44 | $1,348.96 | $5,128.61 |
United Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $416.87 | Professional | None | $114.82 | $151.36 | $416.87 |
Well Sense Setting Facility Modifier None Typical Low $77.62 Median $131.83 Typical High $338.84 | Facility | None | $77.62 | $131.83 | $338.84 |
Well Sense Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | None | $75.86 | $75.86 | $102.33 |
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 $51.29 Median $51.29 Typical High $52.48 | Professional | 52 · Reduced service | $51.29 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | 53 · Discontinued | $20.89 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $79.43 | Professional | 54 · Surgery only | $77.62 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.85 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.72 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $141.25 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $83.18 | $141.25 | $190.55 |
Where Massachusetts sits
The same service costs 8.8 times more in New York 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
NY $2,931MT $332
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.