How much rates vary
Facilitymedian $501 · 10th to 90th $74 to $2,951Professionalmedian $132 · 10th to 90th $72 to $1,445
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 $85.11 Median $85.11 Typical High $251.19 | Professional | None | $85.11 | $85.11 | $251.19 |
AllWays Health Partners Setting Facility Modifier None Typical Low $295.12 Median $537.03 Typical High $2,089.30 | Facility | None | $295.12 | $537.03 | $2,089.30 |
AllWays Health Partners Setting Professional Modifier None Typical Low $67.61 Median $165.96 Typical High $1,445.44 | Professional | None | $67.61 | $165.96 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $794.33 Typical High $977.24 | Facility | None | $478.63 | $794.33 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $169.82 | Professional | None | $89.13 | $89.13 | $169.82 |
Fallon Health Setting Facility Modifier None Typical Low $67.61 Median $85.11 Typical High $3,311.31 | Facility | None | $67.61 | $85.11 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $100.00 | Professional | None | $74.13 | $85.11 | $100.00 |
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 $72.44 Median $141.25 Typical High $239.88 | Professional | None | $72.44 | $141.25 | $239.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $295.12 Median $537.03 Typical High $2,089.30 | Facility | None | $295.12 | $537.03 | $2,089.30 |
Mass General Brigham Setting Professional Modifier None Typical Low $67.61 Median $165.96 Typical High $1,445.44 | Professional | None | $67.61 | $165.96 | $1,445.44 |
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 $77.62 Median $120.23 Typical High $288.40 | Professional | None | $77.62 | $120.23 | $288.40 |
Well Sense Setting Facility Modifier None Typical Low $50.12 Median $89.13 Typical High $346.74 | Facility | None | $50.12 | $89.13 | $346.74 |
Well Sense Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | None | $61.66 | $61.66 | $83.18 |
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 $42.66 Median $42.66 Typical High $125.89 | Professional | 52 · Reduced service | $42.66 | $42.66 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $50.12 | Professional | 53 · Discontinued | $16.98 | $16.98 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $190.55 | Professional | 54 · Surgery only | $63.10 | $63.10 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $38.02 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $25.12 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $25.12 |
Where Massachusetts sits
The same service costs 13.8 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 $2,819MT $205
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.