How much rates vary
Facilitymedian $1,288 · 10th to 90th $257 to $6,166Professionalmedian $562 · 10th to 90th $282 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 $1,230.27 Median $2,818.38 Typical High $5,248.07 | Facility | None | $1,230.27 | $2,818.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $831.76 | Professional | None | $398.11 | $398.11 | $831.76 |
AllWays Health Partners Setting Facility Modifier None Typical Low $645.65 Median $2,884.03 Typical High $8,128.31 | Facility | None | $645.65 | $2,884.03 | $8,128.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $398.11 Median $1,023.29 Typical High $6,606.93 | Professional | None | $398.11 | $1,023.29 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,467.37 Typical High $5,248.07 | Facility | None | $831.76 | $3,467.37 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,318.26 | Professional | None | $512.86 | $512.86 | $1,318.26 |
Fallon Health Setting Facility Modifier None Typical Low $218.78 Median $426.58 Typical High $1,905.46 | Facility | None | $218.78 | $426.58 | $1,905.46 |
Fallon Health Setting Professional Modifier None Typical Low $213.80 Median $380.19 Typical High $549.54 | Professional | None | $213.80 | $380.19 | $549.54 |
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 $416.87 Median $758.58 Typical High $1,548.82 | Professional | None | $416.87 | $758.58 | $1,548.82 |
Health New England Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $12,302.69 | Facility | None | $2,754.23 | $4,466.84 | $12,302.69 |
Health New England Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $645.65 Median $2,884.03 Typical High $8,128.31 | Facility | None | $645.65 | $2,884.03 | $8,128.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $398.11 Median $1,023.29 Typical High $6,606.93 | Professional | None | $398.11 | $1,023.29 | $6,606.93 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $13,489.63 | Facility | None | $1,071.52 | $3,467.37 | $13,489.63 |
United Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $1,737.80 | Professional | None | $436.52 | $616.60 | $1,737.80 |
Well Sense Setting Facility Modifier None Typical Low $309.03 Median $562.34 Typical High $1,698.24 | Facility | None | $309.03 | $562.34 | $1,698.24 |
Well Sense Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $398.11 | Professional | None | $331.13 | $331.13 | $398.11 |
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 $199.53 Median $199.53 Typical High $676.08 | Professional | 52 · Reduced service | $199.53 | $199.53 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $269.15 | Professional | 53 · Discontinued | $79.43 | $79.43 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $302.00 | $302.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $199.53 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $134.90 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $134.90 |
Where Massachusetts sits
The same service costs 7.3 times more in Wisconsin 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
WI $8,816MT $1,205
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.