How much rates vary
Facilitymedian $302 · 10th to 90th $112 to $2,570Professionalmedian $204 · 10th to 90th $120 to $1,175
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 $123.03 Median $123.03 Typical High $398.11 | Professional | None | $123.03 | $123.03 | $398.11 |
AllWays Health Partners Setting Facility Modifier None Typical Low $112.20 Median $323.59 Typical High $1,862.09 | Facility | None | $112.20 | $323.59 | $1,862.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $123.03 Median $309.03 Typical High $1,174.90 | Professional | None | $123.03 | $309.03 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $363.08 Typical High $489.78 | Facility | None | $251.19 | $363.08 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $389.05 | Professional | None | $158.49 | $169.82 | $389.05 |
Fallon Health Setting Facility Modifier None Typical Low $109.65 Median $144.54 Typical High $3,311.31 | Facility | None | $109.65 | $144.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $169.82 | Professional | None | $114.82 | $134.90 | $169.82 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $478.63 | Professional | None | $120.23 | $223.87 | $478.63 |
Mass General Brigham Setting Facility Modifier None Typical Low $112.20 Median $323.59 Typical High $1,862.09 | Facility | None | $112.20 | $323.59 | $1,862.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $123.03 Median $309.03 Typical High $1,174.90 | Professional | None | $123.03 | $309.03 | $1,174.90 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,754.23 | Facility | None | $123.03 | $537.03 | $2,754.23 |
United Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $478.63 | Professional | None | $138.04 | $199.53 | $478.63 |
Well Sense Setting Facility Modifier None Typical Low $102.33 Median $120.23 Typical High $208.93 | Facility | None | $102.33 | $120.23 | $208.93 |
Well Sense Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | None | $100.00 | $100.00 | $120.23 |
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 $61.66 Median $61.66 Typical High $199.53 | Professional | 52 · Reduced service | $61.66 | $61.66 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $79.43 | Professional | 53 · Discontinued | $25.12 | $25.12 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $302.00 | Professional | 54 · Surgery only | $93.33 | $93.33 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $60.26 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $39.81 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $39.81 |
Where Massachusetts sits
The same service costs 8.9 times more in New York than in Maryland. 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 $2,750MD $308
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.