How much rates vary
Facilitymedian $575 · 10th to 90th $240 to $4,786Professionalmedian $603 · 10th to 90th $347 to $6,026
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $1,071.52 | Professional | None | $346.74 | $426.58 | $1,071.52 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $1,737.80 Typical High $5,495.41 | Facility | None | $354.81 | $1,737.80 | $5,495.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $354.81 Median $812.83 Typical High $6,025.60 | Professional | None | $354.81 | $812.83 | $6,025.60 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $331.13 Median $398.11 Typical High $758.58 | Facility | None | $331.13 | $398.11 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $6,309.57 Typical High $9,549.93 | Facility | None | $446.68 | $6,309.57 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $1,174.90 | Professional | None | $446.68 | $562.34 | $1,174.90 |
Fallon Health Setting Facility Modifier None Typical Low $190.55 Median $380.19 Typical High $1,412.54 | Facility | None | $190.55 | $380.19 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $707.95 | Professional | None | $269.15 | $478.63 | $707.95 |
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 $363.08 Median $741.31 Typical High $1,348.96 | Professional | None | $363.08 | $741.31 | $1,348.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $1,737.80 Typical High $5,495.41 | Facility | None | $354.81 | $1,737.80 | $5,495.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $354.81 Median $812.83 Typical High $6,025.60 | Professional | None | $354.81 | $812.83 | $6,025.60 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $13,182.57 | Facility | None | $575.44 | $1,380.38 | $13,182.57 |
United Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $1,513.56 | Professional | None | $398.11 | $588.84 | $1,513.56 |
Well Sense Setting Facility Modifier None Typical Low $275.42 Median $398.11 Typical High $3,388.44 | Facility | None | $275.42 | $398.11 | $3,388.44 |
Well Sense Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $389.05 | Professional | None | $269.15 | $323.59 | $389.05 |
5 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 $173.78 Median $213.80 Typical High $537.03 | Professional | 52 · Reduced service | $173.78 | $213.80 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $85.11 Typical High $213.80 | Professional | 53 · Discontinued | $70.79 | $85.11 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $323.59 Typical High $812.83 | Professional | 54 · Surgery only | $263.03 | $323.59 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $162.18 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $42.66 Typical High $107.15 | Professional | 56 · Pre-op care only | $34.67 | $42.66 | $107.15 |
Where Massachusetts sits
The same service costs 9.3 times more in Wyoming 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
WY $10,585DE $1,135
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.