How much rates vary
Facilitymedian $1,820 · 10th to 90th $692 to $5,888Professionalmedian $1,660 · 10th to 90th $933 to $7,244
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 $2,089.30 Median $2,884.03 Typical High $4,677.35 | Facility | None | $2,089.30 | $2,884.03 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,454.71 | Professional | None | $933.25 | $933.25 | $2,454.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $549.54 Median $2,290.87 Typical High $6,456.54 | Facility | None | $549.54 | $2,290.87 | $6,456.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,023.29 Median $2,238.72 Typical High $7,244.36 | Professional | None | $1,023.29 | $2,238.72 | $7,244.36 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $2,187.76 | Professional | None | $691.83 | $691.83 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,290.87 Typical High $3,311.31 | Facility | None | $676.08 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $3,235.94 | Professional | None | $831.76 | $1,380.38 | $3,235.94 |
Fallon Health Setting Facility Modifier None Typical Low $812.83 Median $1,096.48 Typical High $3,311.31 | Facility | None | $812.83 | $1,096.48 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,548.82 | Professional | None | $954.99 | $1,148.15 | $1,548.82 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $7,762.47 | Facility | None | $741.31 | $2,818.38 | $7,762.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $933.25 Median $1,819.70 Typical High $2,818.38 | Professional | None | $933.25 | $1,819.70 | $2,818.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $549.54 Median $2,290.87 Typical High $6,456.54 | Facility | None | $549.54 | $2,290.87 | $6,456.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,023.29 Median $2,238.72 Typical High $7,244.36 | Professional | None | $1,023.29 | $2,238.72 | $7,244.36 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $10,471.29 | Facility | None | $851.14 | $2,818.38 | $10,471.29 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $3,467.37 | Professional | None | $954.99 | $1,258.93 | $3,467.37 |
Well Sense Setting Facility Modifier None Typical Low $588.84 Median $1,023.29 Typical High $1,445.44 | Facility | None | $588.84 | $1,023.29 | $1,445.44 |
Well Sense Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $794.33 | Professional | None | $660.69 | $660.69 | $794.33 |
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 $467.74 Median $467.74 Typical High $1,230.27 | Professional | 52 · Reduced service | $467.74 | $467.74 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $489.78 | Professional | 53 · Discontinued | $186.21 | $186.21 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $1,819.70 | Professional | 54 · Surgery only | $691.83 | $691.83 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $363.08 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $245.47 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $1,698.24 |
Where Massachusetts sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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
WI $8,254FL $2,626
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.