How much rates vary
Facilitymedian $1,950 · 10th to 90th $759 to $6,918Professionalmedian $1,660 · 10th to 90th $1,072 to $7,079
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 $1,548.82 Median $2,691.53 Typical High $3,715.35 | Facility | None | $1,548.82 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,096.48 | $2,951.21 |
AllWays Health Partners Setting Facility Modifier None Typical Low $588.84 Median $3,019.95 Typical High $9,549.93 | Facility | None | $588.84 | $3,019.95 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,071.52 Median $2,454.71 Typical High $7,079.46 | Professional | None | $1,071.52 | $2,454.71 | $7,079.46 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,047.13 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,754.23 Typical High $4,168.69 | Facility | None | $588.84 | $2,754.23 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,479.11 | $1,479.11 | $2,754.23 |
Fallon Health Setting Facility Modifier None Typical Low $954.99 Median $1,288.25 Typical High $3,311.31 | Facility | None | $954.99 | $1,288.25 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,348.96 | $1,548.82 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $794.33 Median $3,467.37 Typical High $10,232.93 | Facility | None | $794.33 | $3,467.37 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,148.15 | $2,089.30 | $3,467.37 |
Mass General Brigham Setting Facility Modifier None Typical Low $588.84 Median $3,019.95 Typical High $9,549.93 | Facility | None | $588.84 | $3,019.95 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,071.52 Median $2,454.71 Typical High $7,079.46 | Professional | None | $1,071.52 | $2,454.71 | $7,079.46 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $10,964.78 | Facility | None | $1,071.52 | $3,467.37 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,621.81 Typical High $4,365.16 | Professional | None | $1,122.02 | $1,621.81 | $4,365.16 |
Well Sense Setting Facility Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,862.09 | Facility | None | $851.14 | $1,174.90 | $1,862.09 |
Well Sense Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,023.29 | Professional | None | $758.58 | $758.58 | $1,023.29 |
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 $537.03 Median $537.03 Typical High $1,479.11 | Professional | 52 · Reduced service | $537.03 | $537.03 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $588.84 | Professional | 53 · Discontinued | $218.78 | $218.78 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $2,187.76 | Professional | 54 · Surgery only | $812.83 | $812.83 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $446.68 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $295.12 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $2,041.74 |
Where Massachusetts sits
The same service costs 5.3 times more in Vermont than in Hawaii. 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 $13,652HI $2,577
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.