How much rates vary
Facilitymedian $2,089 · 10th to 90th $309 to $6,918Professionalmedian $457 · 10th to 90th $263 to $3,981
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 $1,047.13 Median $2,818.38 Typical High $5,248.07 | Facility | None | $1,047.13 | $2,818.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $1,047.13 | Professional | None | $263.03 | $263.03 | $1,047.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $9,549.93 | Facility | None | $602.56 | $2,398.83 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $257.04 Median $645.65 Typical High $3,981.07 | Professional | None | $257.04 | $645.65 | $3,981.07 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $467.74 | Professional | None | $269.15 | $269.15 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,677.35 Typical High $7,079.46 | Facility | None | $831.76 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $741.31 | Professional | None | $354.81 | $354.81 | $741.31 |
Fallon Health Setting Facility Modifier None Typical Low $269.15 Median $346.74 Typical High $3,311.31 | Facility | None | $269.15 | $346.74 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $398.11 | Professional | None | $295.12 | $338.84 | $398.11 |
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 $295.12 Median $575.44 Typical High $912.01 | Professional | None | $295.12 | $575.44 | $912.01 |
Health New England Setting Facility Modifier None Typical Low $831.76 Median $2,570.40 Typical High $5,011.87 | Facility | None | $831.76 | $2,570.40 | $5,011.87 |
Mass General Brigham Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $9,549.93 | Facility | None | $602.56 | $2,398.83 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $257.04 Median $645.65 Typical High $3,981.07 | Professional | None | $257.04 | $645.65 | $3,981.07 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $12,302.69 | Facility | None | $851.14 | $2,818.38 | $12,302.69 |
United Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $1,258.93 | Professional | None | $354.81 | $549.54 | $1,258.93 |
Well Sense Setting Facility Modifier None Typical Low $223.87 Median $398.11 Typical High $2,398.83 | Facility | None | $223.87 | $398.11 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $331.13 | Professional | None | $245.47 | $245.47 | $331.13 |
7 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 $131.83 Median $131.83 Typical High $524.81 | Professional | 52 · Reduced service | $131.83 | $131.83 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $208.93 | Professional | 53 · Discontinued | $52.48 | $52.48 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $776.25 | Professional | 54 · Surgery only | $194.98 | $194.98 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $154.88 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $104.71 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $104.71 |
BCBS Massachusetts Setting Professional Modifier 62 · Two surgeons Typical Low $165.96 Median $281.84 Typical High $380.19 | Professional | 62 · Two surgeons | $165.96 | $281.84 | $380.19 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $363.08 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $213.80 | $363.08 | $489.78 |
Where Massachusetts sits
The same service costs 13.6 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 $11,880MT $873
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.