How much rates vary
Facilitymedian $759 · 10th to 90th $224 to $4,467Professionalmedian $490 · 10th to 90th $257 to $1,413
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 $257.04 Median $2,884.03 Typical High $5,754.40 | Facility | None | $257.04 | $2,884.03 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $691.83 | Professional | None | $239.88 | $257.04 | $691.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $4,897.79 | Facility | None | $691.83 | $1,737.80 | $4,897.79 |
AllWays Health Partners Setting Professional Modifier None Typical Low $346.74 Median $758.58 Typical High $2,570.40 | Professional | None | $346.74 | $758.58 | $2,570.40 |
BCBS Setting Facility Modifier None Typical Low $309.03 Median $371.54 Typical High $707.95 | Facility | None | $309.03 | $371.54 | $707.95 |
BCBS Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $1,047.13 | Professional | None | $309.03 | $562.34 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,290.87 Typical High $3,388.44 | Facility | None | $588.84 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $912.01 | Professional | None | $354.81 | $416.87 | $912.01 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $354.81 Typical High $1,905.46 | Facility | None | $177.83 | $354.81 | $1,905.46 |
Fallon Health Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $575.44 | Professional | None | $223.87 | $398.11 | $575.44 |
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 $338.84 Median $660.69 Typical High $1,122.02 | Professional | None | $338.84 | $660.69 | $1,122.02 |
Health New England Setting Facility Modifier None Typical Low $1,122.02 Median $4,466.84 Typical High $8,128.31 | Facility | None | $1,122.02 | $4,466.84 | $8,128.31 |
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 $691.83 Median $1,737.80 Typical High $4,897.79 | Facility | None | $691.83 | $1,737.80 | $4,897.79 |
Mass General Brigham Setting Professional Modifier None Typical Low $346.74 Median $758.58 Typical High $2,570.40 | Professional | None | $346.74 | $758.58 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $1,174.90 | Professional | None | $346.74 | $501.19 | $1,174.90 |
Well Sense Setting Facility Modifier None Typical Low $389.05 Median $537.03 Typical High $1,047.13 | Facility | None | $389.05 | $537.03 | $1,047.13 |
Well Sense Setting Professional Modifier None Typical Low $316.23 Median $323.59 Typical High $389.05 | Professional | None | $316.23 | $323.59 | $389.05 |
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 $120.23 Median $128.82 Typical High $416.87 | Professional | 52 · Reduced service | $120.23 | $128.82 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $51.29 Typical High $165.96 | Professional | 53 · Discontinued | $47.86 | $51.29 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $194.98 Typical High $616.60 | Professional | 54 · Surgery only | $177.83 | $194.98 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $125.89 | Professional | 55 · Aftercare only | $35.48 | $38.90 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $83.18 | Professional | 56 · Pre-op care only | $23.99 | $25.70 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $181.97 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $165.96 | $181.97 | $575.44 |
Where Massachusetts sits
The same service costs 6.4 times more in Vermont 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
VT $6,699MT $1,039
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.