How much rates vary
Facilitymedian $2,344 · 10th to 90th $347 to $23,442Professionalmedian $501 · 10th to 90th $309 to $8,318
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 $309.03 Median $309.03 Typical High $831.76 | Professional | None | $309.03 | $309.03 | $831.76 |
AllWays Health Partners Setting Facility Modifier None Typical Low $371.54 Median $4,168.69 Typical High $28,183.83 | Facility | None | $371.54 | $4,168.69 | $28,183.83 |
AllWays Health Partners Setting Professional Modifier None Typical Low $323.59 Median $724.44 Typical High $8,317.64 | Professional | None | $323.59 | $724.44 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $17,782.79 Typical High $26,302.68 | Facility | None | $446.68 | $17,782.79 | $26,302.68 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $831.76 | Professional | None | $446.68 | $446.68 | $831.76 |
Fallon Health Setting Facility Modifier None Typical Low $346.74 Median $457.09 Typical High $3,311.31 | Facility | None | $346.74 | $457.09 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $524.81 | Professional | None | $398.11 | $457.09 | $524.81 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $20,892.96 | Facility | None | $1,096.48 | $4,073.80 | $20,892.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $380.19 Median $691.83 Typical High $1,047.13 | Professional | None | $380.19 | $691.83 | $1,047.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $371.54 Median $4,168.69 Typical High $28,183.83 | Facility | None | $371.54 | $4,168.69 | $28,183.83 |
Mass General Brigham Setting Professional Modifier None Typical Low $323.59 Median $724.44 Typical High $8,317.64 | Professional | None | $323.59 | $724.44 | $8,317.64 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $47,863.01 | Facility | None | $1,258.93 | $4,073.80 | $47,863.01 |
United Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $1,380.38 | Professional | None | $338.84 | $489.78 | $1,380.38 |
Well Sense Setting Facility Modifier None Typical Low $263.03 Median $467.74 Typical High $14,454.40 | Facility | None | $263.03 | $467.74 | $14,454.40 |
Well Sense Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | None | $218.78 | $218.78 | $295.12 |
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 $154.88 Median $154.88 Typical High $416.87 | Professional | 52 · Reduced service | $154.88 | $154.88 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $165.96 | Professional | 53 · Discontinued | $61.66 | $61.66 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $630.96 | Professional | 54 · Surgery only | $234.42 | $234.42 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $125.89 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $83.18 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $588.84 |
Where Massachusetts sits
The same service costs 29.1 times more in Alabama 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
AL $30,626MT $1,051
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.