How much rates vary
Facilitymedian $2,188 · 10th to 90th $708 to $6,918Professionalmedian $1,202 · 10th to 90th $759 to $5,129
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 $1,949.84 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,949.84 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $2,089.30 | Professional | None | $691.83 | $691.83 | $2,089.30 |
AllWays Health Partners Setting Facility Modifier None Typical Low $630.96 Median $2,398.83 Typical High $9,549.93 | Facility | None | $630.96 | $2,398.83 | $9,549.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $758.58 Median $1,819.70 Typical High $5,128.61 | Professional | None | $758.58 | $1,819.70 | $5,128.61 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,698.24 | Professional | None | $794.33 | $794.33 | $1,698.24 |
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 $1,000.00 Median $1,000.00 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,000.00 | $1,995.26 |
Fallon Health Setting Facility Modifier None Typical Low $758.58 Median $1,000.00 Typical High $3,311.31 | Facility | None | $758.58 | $1,000.00 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,174.90 | Professional | None | $870.96 | $1,023.29 | $1,174.90 |
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 $851.14 Median $1,548.82 Typical High $2,344.23 | Professional | None | $851.14 | $1,548.82 | $2,344.23 |
Mass General Brigham Setting Facility Modifier None Typical Low $630.96 Median $2,398.83 Typical High $9,549.93 | Facility | None | $630.96 | $2,398.83 | $9,549.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $758.58 Median $1,819.70 Typical High $5,128.61 | Professional | None | $758.58 | $1,819.70 | $5,128.61 |
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 $851.14 Median $1,174.90 Typical High $3,388.44 | Professional | None | $851.14 | $1,174.90 | $3,388.44 |
Well Sense Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $2,398.83 | Facility | None | $630.96 | $851.14 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | None | $537.03 | $537.03 | $724.44 |
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 $346.74 Median $346.74 Typical High $1,047.13 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $426.58 | Professional | 53 · Discontinued | $138.04 | $138.04 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $1,584.89 | Professional | 54 · Surgery only | $512.86 | $512.86 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $316.23 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $208.93 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $1,479.11 |
BCBS Massachusetts Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $218.78 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $218.78 | $288.40 |
Where Massachusetts sits
The same service costs 5.1 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 $12,267MT $2,405
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.