How much rates vary
Facilitymedian $447 · 10th to 90th $129 to $2,951Professionalmedian $200 · 10th to 90th $107 to $955
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 $1,000.00 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $371.54 | Professional | None | $107.15 | $107.15 | $371.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $269.15 Median $602.56 Typical High $2,089.30 | Facility | None | $269.15 | $602.56 | $2,089.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $112.20 Median $302.00 Typical High $954.99 | Professional | None | $112.20 | $302.00 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $588.84 Typical High $758.58 | Facility | None | $446.68 | $588.84 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $371.54 | Professional | None | $154.88 | $158.49 | $371.54 |
Fallon Health Setting Facility Modifier None Typical Low $114.82 Median $151.36 Typical High $3,311.31 | Facility | None | $114.82 | $151.36 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $177.83 | Professional | None | $123.03 | $144.54 | $177.83 |
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 $125.89 Median $234.42 Typical High $457.09 | Professional | None | $125.89 | $234.42 | $457.09 |
Mass General Brigham Setting Facility Modifier None Typical Low $269.15 Median $602.56 Typical High $2,089.30 | Facility | None | $269.15 | $602.56 | $2,089.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $112.20 Median $302.00 Typical High $954.99 | Professional | None | $112.20 | $302.00 | $954.99 |
United Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $4,168.69 | Facility | None | $407.38 | $870.96 | $4,168.69 |
United Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $457.09 | Professional | None | $123.03 | $186.21 | $457.09 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $138.04 Typical High $269.15 | Facility | None | $87.10 | $138.04 | $269.15 |
Well Sense Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | None | $91.20 | $91.20 | $109.65 |
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 $53.70 Median $53.70 Typical High $186.21 | Professional | 52 · Reduced service | $53.70 | $53.70 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $74.13 | Professional | 53 · Discontinued | $21.38 | $21.38 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $275.42 | Professional | 54 · Surgery only | $79.43 | $79.43 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $54.95 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $37.15 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $37.15 |
Where Massachusetts sits
The same service costs 8.1 times more in New York 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
NY $2,852MT $352
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.