How much rates vary
Facilitymedian $2,399 · 10th to 90th $955 to $7,079Professionalmedian $2,042 · 10th to 90th $1,230 to $8,710
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 $2,570.40 Median $3,388.44 Typical High $6,309.57 | Facility | None | $2,570.40 | $3,388.44 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $3,630.78 | Professional | None | $1,174.90 | $1,174.90 | $3,630.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $724.44 Median $3,388.44 Typical High $10,232.93 | Facility | None | $724.44 | $3,388.44 | $10,232.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,288.25 Median $3,090.30 Typical High $8,709.64 | Professional | None | $1,288.25 | $3,090.30 | $8,709.64 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,318.26 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $4,677.35 Typical High $7,079.46 | Facility | None | $954.99 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,388.44 | Professional | None | $1,698.24 | $1,698.24 | $3,388.44 |
Fallon Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $3,311.31 | Facility | None | $1,202.26 | $1,659.59 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,698.24 | $1,949.84 |
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 $1,412.54 Median $2,630.27 Typical High $3,890.45 | Professional | None | $1,412.54 | $2,630.27 | $3,890.45 |
Mass General Brigham Setting Facility Modifier None Typical Low $724.44 Median $3,388.44 Typical High $10,232.93 | Facility | None | $724.44 | $3,388.44 | $10,232.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,288.25 Median $3,090.30 Typical High $8,709.64 | Professional | None | $1,288.25 | $3,090.30 | $8,709.64 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $14,125.38 | Facility | None | $1,071.52 | $3,467.37 | $14,125.38 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $5,623.41 | Professional | None | $1,445.44 | $1,949.84 | $5,623.41 |
Well Sense Setting Facility Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,398.83 | Facility | None | $1,047.13 | $1,445.44 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,230.27 | Professional | None | $912.01 | $912.01 | $1,230.27 |
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 $588.84 Median $588.84 Typical High $1,819.70 | Professional | 52 · Reduced service | $588.84 | $588.84 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $724.44 | Professional | 53 · Discontinued | $234.42 | $234.42 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $2,691.53 | Professional | 54 · Surgery only | $891.25 | $891.25 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $537.03 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $363.08 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $2,511.89 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,819.70 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,819.70 | $2,398.83 |
Where Massachusetts sits
The same service costs 4.0 times more in Colorado 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
CO $14,661HI $3,664
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.