How much rates vary
Facilitymedian $1,585 · 10th to 90th $398 to $6,166Professionalmedian $1,023 · 10th to 90th $537 to $5,248
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 $741.31 Median $870.96 Typical High $1,348.96 | Professional | None | $741.31 | $870.96 | $1,348.96 |
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 $676.08 Median $1,778.28 Typical High $5,248.07 | Professional | None | $676.08 | $1,778.28 | $5,248.07 |
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 $977.24 Median $977.24 Typical High $2,454.71 | Professional | None | $977.24 | $977.24 | $2,454.71 |
Fallon Health Setting Facility Modifier None Typical Low $338.84 Median $660.69 Typical High $2,691.53 | Facility | None | $338.84 | $660.69 | $2,691.53 |
Fallon Health Setting Professional Modifier None Typical Low $323.59 Median $588.84 Typical High $851.14 | Professional | None | $323.59 | $588.84 | $851.14 |
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 $630.96 Median $1,202.26 Typical High $2,884.03 | Professional | None | $630.96 | $1,202.26 | $2,884.03 |
Health New England Setting Facility Modifier None Typical Low $3,235.94 Median $5,248.07 Typical High $12,882.50 | Facility | None | $3,235.94 | $5,248.07 | $12,882.50 |
Health New England Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,318.26 | $1,737.80 | $1,737.80 |
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 $676.08 Median $1,778.28 Typical High $5,248.07 | Professional | None | $676.08 | $1,778.28 | $5,248.07 |
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 $776.25 Median $1,071.52 Typical High $3,235.94 | Professional | None | $776.25 | $1,071.52 | $3,235.94 |
Well Sense Setting Facility Modifier None Typical Low $588.84 Median $933.25 Typical High $1,698.24 | Facility | None | $588.84 | $933.25 | $1,698.24 |
Well Sense Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | None | $645.65 | $645.65 | $776.25 |
7 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 $436.52 Median $436.52 Typical High $1,288.25 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $512.86 | Professional | 53 · Discontinued | $173.78 | $173.78 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $1,949.84 | Professional | 54 · Surgery only | $645.65 | $645.65 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $389.05 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $257.04 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $1,819.70 |
BCBS Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $501.19 Typical High $676.08 | Professional | 52 · Reduced service | $295.12 | $501.19 | $676.08 |
Where Massachusetts sits
The same service costs 4.9 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 $9,877MT $2,001
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.