How much rates vary
Facilitymedian $525 · 10th to 90th $240 to $3,311Professionalmedian $525 · 10th to 90th $269 to $2,570
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 $1,174.90 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,174.90 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $1,174.90 | Professional | None | $380.19 | $380.19 | $1,174.90 |
AllWays Health Partners Setting Facility Modifier None Typical Low $354.81 Median $794.33 Typical High $2,089.30 | Facility | None | $354.81 | $794.33 | $2,089.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $363.08 Median $977.24 Typical High $2,570.40 | Professional | None | $363.08 | $977.24 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,754.23 Typical High $4,168.69 | Facility | None | $446.68 | $2,754.23 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $1,230.27 | Professional | None | $489.78 | $489.78 | $1,230.27 |
Fallon Health Setting Facility Modifier None Typical Low $204.17 Median $398.11 Typical High $1,412.54 | Facility | None | $204.17 | $398.11 | $1,412.54 |
Fallon Health Setting Professional Modifier None Typical Low $199.53 Median $363.08 Typical High $524.81 | Professional | None | $199.53 | $363.08 | $524.81 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $4,168.69 | Facility | None | $363.08 | $794.33 | $4,168.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $389.05 Median $724.44 Typical High $1,318.26 | Professional | None | $389.05 | $724.44 | $1,318.26 |
Mass General Brigham Setting Facility Modifier None Typical Low $354.81 Median $794.33 Typical High $2,089.30 | Facility | None | $354.81 | $794.33 | $2,089.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $363.08 Median $977.24 Typical High $2,570.40 | Professional | None | $363.08 | $977.24 | $2,570.40 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $8,128.31 | Facility | None | $407.38 | $870.96 | $8,128.31 |
United Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $1,621.81 | Professional | None | $416.87 | $549.54 | $1,621.81 |
Well Sense Setting Facility Modifier None Typical Low $275.42 Median $398.11 Typical High $1,174.90 | Facility | None | $275.42 | $398.11 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $346.74 | Professional | None | $288.40 | $288.40 | $346.74 |
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 $190.55 Median $190.55 Typical High $588.84 | Professional | 52 · Reduced service | $190.55 | $190.55 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $234.42 | Professional | 53 · Discontinued | $75.86 | $75.86 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $891.25 | Professional | 54 · Surgery only | $281.84 | $281.84 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $177.83 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $117.49 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $117.49 |
Where Massachusetts sits
The same service costs 5.2 times more in Alaska 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
AK $4,868DE $935
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.