How much rates vary
Facilitymedian $2,399 · 10th to 90th $794 to $7,943Professionalmedian $1,380 · 10th to 90th $813 to $6,166
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 $812.83 Median $812.83 Typical High $2,344.23 | Professional | None | $812.83 | $812.83 | $2,344.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $707.95 Median $3,548.13 Typical High $10,232.93 | Facility | None | $707.95 | $3,548.13 | $10,232.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $794.33 Median $2,089.30 Typical High $6,165.95 | Professional | None | $794.33 | $2,089.30 | $6,165.95 |
BCBS Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,995.26 | Professional | None | $933.25 | $933.25 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,677.35 Typical High $7,079.46 | Facility | None | $676.08 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,174.90 | $2,290.87 |
Fallon Health Setting Facility Modifier None Typical Low $831.76 Median $1,148.15 Typical High $3,311.31 | Facility | None | $831.76 | $1,148.15 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,174.90 | $1,380.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $977.24 Median $1,819.70 Typical High $2,754.23 | Professional | None | $977.24 | $1,819.70 | $2,754.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $707.95 Median $3,548.13 Typical High $10,232.93 | Facility | None | $707.95 | $3,548.13 | $10,232.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $794.33 Median $2,089.30 Typical High $6,165.95 | Professional | None | $794.33 | $2,089.30 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,595.87 | Facility | None | $1,071.52 | $3,890.45 | $16,595.87 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,288.25 Typical High $3,801.89 | Professional | None | $794.33 | $1,288.25 | $3,801.89 |
Well Sense Setting Facility Modifier None Typical Low $724.44 Median $1,288.25 Typical High $2,398.83 | Facility | None | $724.44 | $1,288.25 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $831.76 | Professional | None | $616.60 | $616.60 | $831.76 |
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 $407.38 Median $407.38 Typical High $1,174.90 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $467.74 | Professional | 53 · Discontinued | $162.18 | $162.18 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $1,737.80 | Professional | 54 · Surgery only | $602.56 | $602.56 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $354.81 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $234.42 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $1,621.81 |
Where Massachusetts sits
The same service costs 5.6 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 $14,385HI $2,567
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.