How much rates vary
Facilitymedian $871 · 10th to 90th $363 to $4,266Professionalmedian $741 · 10th to 90th $363 to $1,820
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 $776.25 Median $2,691.53 Typical High $3,715.35 | Facility | None | $776.25 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $776.25 | Professional | None | $239.88 | $371.54 | $776.25 |
AllWays Health Partners Setting Facility Modifier None Typical Low $457.09 Median $1,778.28 Typical High $5,011.87 | Facility | None | $457.09 | $1,778.28 | $5,011.87 |
AllWays Health Partners Setting Professional Modifier None Typical Low $371.54 Median $851.14 Typical High $4,265.80 | Professional | None | $371.54 | $851.14 | $4,265.80 |
BCBS Setting Facility Modifier None Typical Low $363.08 Median $436.52 Typical High $831.76 | Facility | None | $363.08 | $436.52 | $831.76 |
BCBS Setting Professional Modifier None Typical Low $363.08 Median $676.08 Typical High $1,174.90 | Professional | None | $363.08 | $676.08 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,659.59 Typical High $2,398.83 | Facility | None | $588.84 | $1,659.59 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $1,348.96 | Professional | None | $407.38 | $660.69 | $1,348.96 |
Fallon Health Setting Facility Modifier None Typical Low $354.81 Median $467.74 Typical High $3,311.31 | Facility | None | $354.81 | $467.74 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,023.29 | Professional | None | $724.44 | $851.14 | $1,023.29 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $389.05 Median $831.76 Typical High $1,621.81 | Professional | None | $389.05 | $831.76 | $1,621.81 |
Mass General Brigham Setting Facility Modifier None Typical Low $457.09 Median $1,778.28 Typical High $5,011.87 | Facility | None | $457.09 | $1,778.28 | $5,011.87 |
Mass General Brigham Setting Professional Modifier None Typical Low $371.54 Median $851.14 Typical High $4,265.80 | Professional | None | $371.54 | $851.14 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $9,120.11 | Facility | None | $1,047.13 | $2,344.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $338.84 Median $660.69 Typical High $1,479.11 | Professional | None | $338.84 | $660.69 | $1,479.11 |
Well Sense Setting Facility Modifier None Typical Low $302.00 Median $537.03 Typical High $851.14 | Facility | None | $302.00 | $537.03 | $851.14 |
Well Sense Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $398.11 | Professional | None | $218.78 | $263.03 | $398.11 |
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 $120.23 Median $186.21 Typical High $389.05 | Professional | 52 · Reduced service | $120.23 | $186.21 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $74.13 Typical High $154.88 | Professional | 53 · Discontinued | $47.86 | $74.13 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $275.42 Typical High $588.84 | Professional | 54 · Surgery only | $181.97 | $275.42 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $56.23 Typical High $117.49 | Professional | 55 · Aftercare only | $36.31 | $56.23 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $37.15 Typical High $77.62 | Professional | 56 · Pre-op care only | $23.99 | $37.15 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $257.04 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $169.82 | $257.04 | $549.54 |
Where Massachusetts sits
The same service costs 5.3 times more in Colorado 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
CO $6,438MT $1,226
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.