How much rates vary
Facilitymedian $1,175 · 10th to 90th $389 to $4,898Professionalmedian $832 · 10th to 90th $427 to $5,370
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 $1,778.28 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,778.28 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,778.28 | Professional | None | $575.44 | $575.44 | $1,778.28 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $5,888.44 | Facility | None | $602.56 | $2,041.74 | $5,888.44 |
AllWays Health Partners Setting Professional Modifier None Typical Low $562.34 Median $1,584.89 Typical High $5,370.32 | Professional | None | $562.34 | $1,584.89 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $3,311.31 | Facility | None | $831.76 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,905.46 | Professional | None | $776.25 | $776.25 | $1,905.46 |
Fallon Health Setting Facility Modifier None Typical Low $331.13 Median $645.65 Typical High $2,691.53 | Facility | None | $331.13 | $645.65 | $2,691.53 |
Fallon Health Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $831.76 | Professional | None | $323.59 | $575.44 | $831.76 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $630.96 Median $1,148.15 Typical High $2,041.74 | Professional | None | $630.96 | $1,148.15 | $2,041.74 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $5,888.44 | Facility | None | $602.56 | $2,041.74 | $5,888.44 |
Mass General Brigham Setting Professional Modifier None Typical Low $562.34 Median $1,584.89 Typical High $5,370.32 | Professional | None | $562.34 | $1,584.89 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,332.54 | Facility | None | $1,047.13 | $2,344.23 | $9,332.54 |
United Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $2,344.23 | Professional | None | $602.56 | $870.96 | $2,344.23 |
Well Sense Setting Facility Modifier None Typical Low $457.09 Median $691.83 Typical High $1,174.90 | Facility | None | $457.09 | $691.83 | $1,174.90 |
Well Sense Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $524.81 | Professional | None | $436.52 | $436.52 | $524.81 |
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 $288.40 Median $288.40 Typical High $891.25 | Professional | 52 · Reduced service | $288.40 | $288.40 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $354.81 | Professional | 53 · Discontinued | $114.82 | $114.82 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $1,318.26 | Professional | 54 · Surgery only | $426.58 | $426.58 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $269.15 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $177.83 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $1,230.27 |
Where Massachusetts sits
The same service costs 4.1 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 $7,274MT $1,783
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.