How much rates vary
Facilitymedian $1,585 · 10th to 90th $589 to $7,244Professionalmedian $1,318 · 10th to 90th $676 to $6,607
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 $6,309.57 | Facility | None | $2,691.53 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,041.74 | Professional | None | $933.25 | $933.25 | $2,041.74 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $3,467.37 Typical High $9,772.37 | Facility | None | $724.44 | $3,467.37 | $9,772.37 |
AllWays Health Partners Setting Professional Modifier None Typical Low $912.01 Median $2,454.71 Typical High $6,606.93 | Professional | None | $912.01 | $2,454.71 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $6,456.54 Typical High $9,772.37 | Facility | None | $954.99 | $6,456.54 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $3,090.30 | Professional | None | $1,230.27 | $1,230.27 | $3,090.30 |
Fallon Health Setting Facility Modifier None Typical Low $524.81 Median $1,000.00 Typical High $2,187.76 | Facility | None | $524.81 | $1,000.00 | $2,187.76 |
Fallon Health Setting Professional Modifier None Typical Low $512.86 Median $912.01 Typical High $1,318.26 | Professional | None | $512.86 | $912.01 | $1,318.26 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,000.00 Median $1,819.70 Typical High $3,630.78 | Professional | None | $1,000.00 | $1,819.70 | $3,630.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $3,467.37 Typical High $9,772.37 | Facility | None | $724.44 | $3,467.37 | $9,772.37 |
Mass General Brigham Setting Professional Modifier None Typical Low $912.01 Median $2,454.71 Typical High $6,606.93 | Professional | None | $912.01 | $2,454.71 | $6,606.93 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $15,848.93 | Facility | None | $1,071.52 | $3,467.37 | $15,848.93 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $4,073.80 | Professional | None | $977.24 | $1,318.26 | $4,073.80 |
Well Sense Setting Facility Modifier None Typical Low $676.08 Median $912.01 Typical High $1,380.38 | Facility | None | $676.08 | $912.01 | $1,380.38 |
Well Sense Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | None | $724.44 | $724.44 | $851.14 |
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 $467.74 Median $467.74 Typical High $1,445.44 | Professional | 52 · Reduced service | $467.74 | $467.74 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $575.44 | Professional | 53 · Discontinued | $190.55 | $190.55 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $2,137.96 | Professional | 54 · Surgery only | $707.95 | $707.95 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $436.52 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $288.40 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $1,995.26 |
Where Massachusetts sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.