How much rates vary
Facilitymedian $525 · 10th to 90th $191 to $3,090Professionalmedian $525 · 10th to 90th $295 to $3,311
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 $1,230.27 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,230.27 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $933.25 | Professional | None | $354.81 | $354.81 | $933.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $131.83 Median $602.56 Typical High $2,818.38 | Facility | None | $131.83 | $602.56 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $316.23 Median $691.83 Typical High $3,311.31 | Professional | None | $316.23 | $691.83 | $3,311.31 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $851.14 | Professional | None | $389.05 | $389.05 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $1,380.38 | Facility | None | $831.76 | $831.76 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $1,000.00 | Professional | None | $295.12 | $436.52 | $1,000.00 |
Fallon Health Setting Facility Modifier None Typical Low $263.03 Median $338.84 Typical High $3,311.31 | Facility | None | $263.03 | $338.84 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $457.09 | Professional | None | $281.84 | $338.84 | $457.09 |
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 $281.84 Median $549.54 Typical High $776.25 | Professional | None | $281.84 | $549.54 | $776.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $131.83 Median $602.56 Typical High $2,818.38 | Facility | None | $131.83 | $602.56 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $316.23 Median $691.83 Typical High $3,311.31 | Professional | None | $316.23 | $691.83 | $3,311.31 |
United Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $2,818.38 | Facility | None | $117.49 | $537.03 | $2,818.38 |
United Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $1,122.02 | Professional | None | $346.74 | $478.63 | $1,122.02 |
Well Sense Setting Facility Modifier None Typical Low $213.80 Median $295.12 Typical High $724.44 | Facility | None | $213.80 | $295.12 | $724.44 |
Well Sense Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $295.12 | Professional | None | $245.47 | $245.47 | $295.12 |
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 $177.83 Median $177.83 Typical High $467.74 | Professional | 52 · Reduced service | $177.83 | $177.83 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $186.21 | Professional | 53 · Discontinued | $70.79 | $70.79 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $691.83 | Professional | 54 · Surgery only | $263.03 | $263.03 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $138.04 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $93.33 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $93.33 |
Where Massachusetts sits
The same service costs 10.0 times more in New York than in Delaware. 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 $4,696DE $472
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.