How much rates vary
Facilitymedian $2,399 · 10th to 90th $776 to $7,244Professionalmedian $1,698 · 10th to 90th $1,023 to $7,413
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 $912.01 Median $912.01 Typical High $2,754.23 | Professional | None | $912.01 | $912.01 | $2,754.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $588.84 Median $3,235.94 Typical High $10,232.93 | Facility | None | $588.84 | $3,235.94 | $10,232.93 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,096.48 Median $2,570.40 Typical High $7,413.10 | Professional | None | $1,096.48 | $2,570.40 | $7,413.10 |
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 $1,412.54 Median $1,412.54 Typical High $2,818.38 | Professional | None | $1,412.54 | $1,412.54 | $2,818.38 |
Fallon Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $3,311.31 | Facility | None | $1,023.29 | $1,412.54 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,445.44 | $1,698.24 |
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 $1,202.26 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,202.26 | $2,238.72 | $3,311.31 |
Mass General Brigham Setting Facility Modifier None Typical Low $588.84 Median $3,235.94 Typical High $10,232.93 | Facility | None | $588.84 | $3,235.94 | $10,232.93 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,096.48 Median $2,570.40 Typical High $7,413.10 | Professional | None | $1,096.48 | $2,570.40 | $7,413.10 |
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 $1,148.15 Median $1,621.81 Typical High $4,677.35 | Professional | None | $1,148.15 | $1,621.81 | $4,677.35 |
Well Sense Setting Facility Modifier None Typical Low $851.14 Median $1,202.26 Typical High $2,398.83 | Facility | None | $851.14 | $1,202.26 | $2,398.83 |
Well Sense Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $954.99 | Professional | None | $707.95 | $707.95 | $954.99 |
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 $457.09 Median $457.09 Typical High $1,380.38 | Professional | 52 · Reduced service | $457.09 | $457.09 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $549.54 | Professional | 53 · Discontinued | $181.97 | $181.97 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $2,089.30 | Professional | 54 · Surgery only | $691.83 | $691.83 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $416.87 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $275.42 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $1,949.84 |
Where Massachusetts sits
The same service costs 5.1 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 $14,362HI $2,794
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.